超声清创治疗慢性创面的疗效观察

目的探讨应用多功能清创仪对慢性创面进行超声清创治疗的临床效果。 方法将2016年10月至2018年10月黑龙江省医院烧伤科收治的、符合入选标准的60例慢性创面患者按随机数字表法分为治疗组和对照组，每组30例。治疗组患者适当清除创面坏死组织后，采用多功能清创仪进行超声清创治疗2周，每周2次；对照组患者应用传统床旁清创和隔日换药治疗。2组患者首次清创治疗前、后12 d分别取创面标本送检。记录2组患者首次清创治疗前及治疗后12 d的创面细菌数量、创面细菌清除率和创面日本褥疮经过评价标准各指标评分。数据比较采用t检验和χ²检验。 结果首次清创治疗前，治疗组与对照组患者创面检测出金黄色葡萄球菌、表皮葡萄球菌、大肠杆菌、铜绿假单胞菌，菌落数比较差异均无统计学意义(P值均大于0.05)；治疗后12 d，2组患者创面对应细菌数比较，差异均有统计学意义(P值均小于0.05)。清创治疗后12 d，治疗组患者创面金黄色葡萄球菌、表皮葡萄球菌、大肠杆菌、铜绿假单胞菌，细菌清除率分别为(77.66±4.18)%、(76.12±5.14)%、(80.69±4.92)%、(75.95±3.16)%，与对照组(42.64±2.37)%、(37.14±2.68)%、(27.12±3.17)%、(41.77±2.59)%比较，差异均有统计学意义(t＝5.39、3.97、3.87、5.37，P值均小于0.05)。首次清创治疗前2组患者创面情况比较差异均无统计学意义(P值均大于0.05)。治疗后12 d治疗组日本褥疮经过评价标准综合评分总分(13.60±3.28) 分，与对照组治疗后12 d (20.33±4.79) 分相比，差异有统计学意义(t＝6.14，P<0.05)。 结论多功能清创仪超声清创治疗慢性创面的临床效果较佳，值得临床治疗推广。

Observation on the effect of ultrasonic debridement in the treatment of chronic wounds

ObjectiveTo investigate the clinical effect of multifunctional debridement instrument in the treatment of chronic wounds. MethodsSixty patients with chronic wounds admitted to the Department of Burns, Heilongjiang Provincial Hospital from October 2016 to October 2018 and meeted the inclusion criteria were divided into treatment group and control group according to the random number toble method, 30 cases in each group. After the patients in the control group were properly removed from the wound necrotic tissue, the multifunctional ultrasonic debridement instrument was performed twice a week for 2 weeks and 4 times. The patients in the control group were treated with traditional bedside debridement and changed dressing every other day. The wounds sample of the two groups were taken for examination before and 12 days after the first debridement. The number of wound bacteria, wound bacterial clearance rate and wound DESIGN-R score before and 12 days after the first debridement treatment in the 2 groups were recorded. Data were processed with t test and chi-square test. ResultsBefore the first debridement treatment, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa were quantitatively detected on the wound surface of the patients in the two groups, the differences were not statistically significant (with P values above 0.05). At 12 days after treatment, there were statistically significant differences in the number of bacterial on the wound surface between the two groups (with P values below 0.05), the bacterial clearance rates of the Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa in the treatment group were (77.66±4.18)%, (76.12±5.14)%, (80.69±4.92)%, (75.95±3.16)%, and the control group were (42.64±2.37)%, (37.14±2.68)%, (27.12±3.17)%, (41.77±2.59)%, the differences were statistically significant (t=5.39, 3.97, 3.87, 5.37; with P values below 0.05). There were no significant differences in the DESIGN-R scores between the two groups before treatment (with P values above 0.05). The total score was (13.60±3.28) points in the treatment group 12 days after treatment, which was (20.33±4.79) points in the control group, the difference between the two groups was statistically significant (t=6.14, P<0.05). ConclusionThe multifunctional debridement instrument for ultrasonic debridement has a better clinical effect in treating chronic wounds, which is worthy of clinical treatment.