两种银敷料在下肢静脉溃疡治疗中应用效果观察

摘要

目的：观察两种银敷料用于下肢静脉溃疡治疗的效果，以指导银敷料在伤口治疗中的合理使用。方法对入选的75例下肢静脉溃疡患者随机分为观察组和对照组，观察组使用进口的银离子藻酸盐敷料，对照组使用国产纳米银敷料处理局部溃疡，两组患肢均给予弹力绷带压力治疗，并接受28 d的治疗方案，研究结束时伤口未愈者选择湿性愈合技术处理至愈合或外科手术治愈。观察治疗7 d、14 d、21 d时溃疡伤口细菌转阴率，研究结束时溃疡面积愈合率和愈合效果，并于每次处理伤口时观察评价伤口床表现(渗液清除时间、肉芽分级和周围皮肤状况)。结果两组伤口面积愈合率平均为(84.66±10.56)%和(67.33±9.44)%，其中，观察组完全愈合8例、基本愈合17例、有效12例，对照组完全愈合4例、基本愈合11例、有效22例，两组差异均有统计学意义(P<0.05)；两组伤口细菌转阴率随着时间的延长均增加，28 d时细菌转阴率均达100%，差异无统计学意义(P>0.05)；随着治疗时间的增加，两组伤口表现也显著改善，观察组的效果要明显优于对照组，差异有统计学意义(P<0.05)。结论两种银敷料均可清除溃疡伤口感染，改善伤口床的表现，促进溃疡愈合，银敷料治疗下肢静脉性溃疡伤口有效，但银离子藻酸盐敷料的有效性更优越。%Objective To observe the effects of two silver dressing in the treatment of venous leg ulcer, and to guide proper use of silver dressings on wound treatments. Methods Seventy-five patients with venous leg ulcers were randomly divided into two groups:the observation group and the control group. The observation group was treat-ed with imported silver ion alginate dressing, and the control group was treated with domestic nanometer silver dress-ing. Elastic bandages were applied to affect extremities of two groups. The treatment lasted for 28 days. The bacterial clearance rate of ulcer wound was compared 7 d, 14 d, 21 d after treatment. The performance of the wound bed (fluid clearance time, granulation grading and the surrounding skin condition) was observed whenever the wound was cared. The healing rate and effect of ulcer area was evaluated at the end of the research. Results The average healing rate of the two groups was (84.66±10.56)%and (67.33±9.44)%. In the observation group, 8 cases were completely healed,17 cases were almost healed, 12 cases were effective. In the control group, 4 cases were completely healed, 11 cases were almost healed, 22 cases were effective. The two groups showed statistically significant difference (P<0.05). The bacte-rial clearance rate of ulcer wound in the two groups increased with time, which both reached 100%28 d after treat-ment, with no statistically significant difference. There was significant improvement in the performance of wound bed in the two groups. The effect of the observation group was more significant than the control group, and the difference was statistically significant (P<0.05).Conclusion Both the two silver dressings can clear wound infection, improve wound performance, and promote wound healing. Silver dressings are effective for treating venous leg ulcer wound, but the effectiveness of the silver ion alginate dressing is superior.