烧伤残余创面局部应用四环素眼膏治疗的临床观察

目的观察四环素眼膏在烧伤残余创面治疗中的临床效果。方法 84例烧伤残余创面的患者根据创面应用药物不同分为3组,创面应用四环素眼膏治疗的患者归入四环素眼膏组(简称眼膏组)、创面应用重组人表皮生长因子的患者归入rhEGF凝胶组(简称凝胶组)和创面应用传统碘伏油纱换药治疗的患者归入碘伏油纱组(简称油纱组),观察创面愈合时间、疼痛度、治疗费用、1年后随访效果和创面细菌培养的结果。结果 (1)眼膏组和凝胶组治疗烧伤残余创面的愈合时间均短于油纱组,平均提前3～5d(P0.01),眼膏组与凝胶组的愈合时间差异无统计学意义(P0.05)。(2)眼膏组平均疼痛度评分为(2.56±0.14)分,与凝胶组疼痛度评分(2.61±0.07)分比较差异无统计学意义(P0.05);碘伏油纱组疼痛度评分为(4.23±0.26)分,与眼膏组和凝胶组比较差异有统计学意义(P0.01)。(3)治愈每1%残余创面所需敷料和药物费用眼膏组费用最低:(121.35±1.16)元,油纱组次之:(269.17±3.6)元,凝胶组较为昂贵:(449±17.2)元。(4)1年后对部分患者随访,根据相应评价指标进行评分,预后眼膏组(5.23±0.26)分和凝胶组(6.13±0.32)分明显优于油纱组(3.98±0.46)分,P0.01,眼膏组与凝胶组比较差异无统计学意义(P0.05)。(5)创面分泌物细菌培养72h可见凝胶组细菌阳性率最高(42.31%),油纱组72h细菌培养阳性率(16.13%)明显低于凝胶组,眼膏组细菌培养阳性率(3.70%)又明显低于油纱组。结论四环素眼膏治疗烧伤残余创面对比于重组人表皮生长因子和碘伏油纱,能有效控制感染,缩短愈合时间,减轻患者疼痛度,同时降低治疗费用,效果确切、预后良好。

Clinical observation of tetracycline eye ointment in the treatment of residual burn wounds

Objective To observe the clinical effect of the tetracycline eye-ointment in the treatment of residual burn wounds. Methods Eighty-four cases of residual burn wounds were divided into 3 groups： tetracycline eye-ointment group （eye-ointment group）, rhEGF gel group （gel group） and iodine-gauze group （gauze group）. And then we investigated and compared the healing time, the degree of pain, the cost of treatment, and 1 year follow-up and the results of bacterial culture of the 3 groups. Results （1）The healing time： gauze grou Pgel grou Peye-ointment group, eye-ointment group and gel group had shorter healing time about 3 to 5 days than gauze group,（P0.01）, but eye-ointment group and gel group were not different （P0.05）; （2）The patients of gel group and eye-ointment group had lighter pain in contrast with gauze group （P0.01）; （3）For curing 1%TBSA residual wound, eye-ointment group had minimum cost, followed by gauze group, while gel group had the highest cost; （4）one year follow-up of eye-ointment group and gel group showed better long-term effect, and less scar hyperplasia; （5）The bacterial culture showed that the antimicrobial effect of tetracycline eye-ointment was better than iodophor gauze, while the iodophor gauze was obviously superior to recombinant human epidermal growth factor gel（P0.01）.Conclusion Tetracycline eye-ointment by contrast with recombinant human epidermal growth factor gel and iodophor gauze could effectively control the infections, shorten healing time, alleviate patients’ pain reduce cost of treatment, and provide better prognosis in the treatment of residual burn wound .