痊愈妥粘性敷料用于Ⅱ期以上压疮的疗效观察

[目的]探讨采用痊愈妥粘性敷料处理Ⅱ期以上压疮的临床效果。[方法]将60例压疮病人随机分为实验组和对照组各30例,创面均给予常规清创处理后,实验组用痊愈妥粘性敷料覆盖,对照组采用无菌纱布覆盖。[结果]实验组压疮愈合时间比对照组明显缩短(P<0.05);实验组压疮治疗效果、疼痛改善程度显明显优于对照组(P<0.05)。[结论]痊愈妥粘性敷料能够明显缩短压疮创面愈合时间、提高治愈率、减轻病人疼痛。     

痊愈妥敷料治疗糖尿病足的效果观察

目的 探讨痊愈妥敷料治疗糖尿病足的临床效果.方法 将78例糖尿病足患者随机分为痊愈妥敷料组和外科换药组,每组各39例,比较2组患者的治愈率.结果 痊愈妥敷料组治愈率高于外科换药组(x2=8.03,p<0.01),差别有统计学意义.结论 痊愈妥敷料治疗糖尿病足具有创面愈合快,提高治疗效果的作用,在临床上值得推广.     

重组人表皮生长因子辅助纳米银敷料治疗Ⅱ度烧伤的疗效

目的探讨重组人表皮生长因子辅助纳米银敷料治疗Ⅱ度烧伤的临床效果。方法将111例Ⅱ度烧伤患者按随机数字表法分为2组:对照组55例(深Ⅱ度烧伤28例、浅Ⅱ度烧伤27例)采用纳米银敷料治疗;观察组56例(深Ⅱ度烧伤27例、浅Ⅱ度烧伤29例)采用重组人表皮生长因子辅助纳米银敷料治疗。2组治疗后7、14、28d对烧伤创面分泌物进行细菌培养和鉴定,比较2组烧伤创面细菌检出率、不同时段愈合率及愈合时间。结果观察组治疗后浅Ⅱ度烧伤创面菌检出率较对照组显著减少(P=0.041);深Ⅱ度烧伤创面治疗14、28d后愈合率明显高于对照组(P=0.033、0.039),浅Ⅱ度烧伤创面治疗7d后愈合率明显高于对照组(P=0.018);深Ⅱ度烧伤创面与浅Ⅱ度烧伤创面愈合时间均显著短于对照组(P=0.001、0.000)。结论重组人表皮生长因子辅助纳米银敷料治疗Ⅱ度烧伤可有效灭菌,控制感染;同时可促进成纤维细胞及上皮细胞增殖,促进新生肉芽形成,达到加速创面愈合的效果。     

痊愈妥加通心络粉末治疗Ⅱ期及Ⅲ期压疮的临床观察

[目的]探讨痊愈妥粘性敷料加通心络胶囊粉末在Ⅱ期～Ⅲ期压疮创面修复中的作用.[方法]将Ⅱ期～Ⅲ期压疮病人应用随机方法分成实验组、对照1组和对照2组.实验组给予痊愈妥加通心络胶囊粉末护理创面,对照1组给予痊愈妥敷料护理创面,对照2组应用湿润烧伤膏护理创面[结果]实验组创面痊愈需要时间优于对照组,3组比较差异有统计学意义(P＜0.05和P＜0.01).[结论]痊愈妥粘性敷料加通心络胶囊粉末用于Ⅱ期～Ⅲ期压疮护理,效果显著,使用方便.     

爱康肤银离子敷料治疗小儿深Ⅱ度烧伤的效果观察

[目的]观察爱康肤银离子敷料治疗小儿深Ⅱ度烧伤的效果。[方法]将60例深Ⅱ度烧伤患儿随机分为对照组和观察组各30例,对照组采用传统的创面处理方法,观察组用爱康肤银离子敷料覆盖于创面,用无菌敷料包扎固定。观察两组患儿创面愈合时间、换药次数、单次换药耗时。[结果]观察组患儿创面愈合时间、单次换药耗时短于对照组,换药次数少于对照组(P0.05)。[结论]爱康肤银离子敷料治疗小儿深Ⅱ度烧伤的效果优于传统的创面处理方法。     

纳米银敷料与磺胺嘧啶银霜治疗烧伤创面的临床效果比较

目的观察纳米银敷料与磺胺嘧啶银霜治疗烧伤创面的临床效果。方法选取60例烧伤患者,随机分为对照组和试验组,每组30例。对照组给予磺胺嘧啶银霜涂抹治疗烧伤创面,试验组则给予纳米银敷料覆盖于创面,观察两组治疗效果。结果试验组创面愈合时间平均为8.4±2.6d,明显短于对照组的14.0±3.1d,差异具有统计学意义(P0.05),试验组手术植皮率与创面瘢痕率明显低于对照组(P0.05)。两组毒副反应及细菌感染率差异无统计学意义(P0.05)。结论烧伤患者应用纳米银敷料有利于加速创面愈合,缩短恢复时间,疗效显著,值得推广应用。     

重组人表皮生长因子对面部Ⅱ度烧伤创面修复相关作用的比较

目的:观察外用重组人表皮生长因子对面部Ⅱ度烧伤创面修复过程中的治疗作用和安全性。方法:选择2002-06/2004-06广西医科大学第一附属医院烧伤整形康复中心收治的面部浅Ⅱ度烧伤、深Ⅱ度烧伤各60例。以面部左侧为治疗组,右侧为对照组。伤后第3天,治疗组将2000IU/mL的重组人表皮生长因子直接湿敷于创面上半暴露,换药1次/d,至创面愈合;对照组创面单用等渗盐水纱布覆盖半暴露,换药1次/d,至创面愈合。7和14d观察两组患者创面愈合率、愈合时间、疼痛及瘢痕情况及不良反应。采用目测类比评分法(VAS)评估疼痛情况(0分为无痛,10分为极痛);采用改良温哥华瘢痕测量法测定深Ⅱ度创面瘢痕增生情况(瘢痕指数)。结果:120例患者均进入结果分析。两组患者创面愈合率、愈合时间、疼痛及瘢痕情况的比较:浅Ⅱ度烧伤创面,治疗组7d愈合率显著高于对照组[(72.15±13.26)%,(59.28±11.35)%,t=5.7115,P<0.01],愈合时间较对照组明显缩短[(9.62±2.38),(11.27±2.95)d,t=3.3719,P<0.01];深Ⅱ度烧伤创面,治疗组14d愈合率显著高于对照组[(75.03±21.32)%,(61.24±18.29)%,t=3.8026,P<0.01],愈合时间较对照组明显缩短[(17.62±3.49),(20.86±3.97)d,t=4.7772,P<0.01],瘢痕指数低于对照组[(7.32±1.67),(8.78±1.95),t=4.2541,P<0.01];两组患者两种创面疼痛评分无明显差别。治疗组治疗过程未见明显毒副作用及不良反应。结论:外用重组人表皮生长因子能显著加快面部Ⅱ度烧伤创面的愈合速度,缩短愈合时间,提高愈合质量,减少瘢痕的形成,无明显不良反应,安全性好。     

聚硅酮泡沫联合水胶体敷料在儿童Ⅱ°烧伤创面中的应用效果

目的探讨聚硅酮泡沫敷料联合水胶体敷料治疗儿童小面积(5%)Ⅱ°烧伤创面的临床效果。方法将122例烧伤患者,采用随机方法分为观察组和对照组2组。两组均常规采用1%聚维酮碘消毒创面,生理盐水清洗干净后无菌纱布蘸干,在此基础上,对照组内层用优拓+1%碘伏油纱覆盖,外层用无菌纱布包扎;观察组在前3d内层用聚硅酮泡沫敷料覆盖创面,3d后渗液减少内层改用水胶体敷料,外层用无菌纱布包扎;分别观察2组愈合时间、换药疼痛程度、换药次数、并发症和愈合质量。结果观察组愈合时间、换药次数、疼痛程度、愈合质量均优于对照组,差异均有统计学意义(P0.05)。结论聚硅酮泡沫敷料联合水胶体敷料治疗儿童小面积(5%)Ⅱ°烧伤创面可缩短创面愈合时间、减少换药次数和疼痛,效果确切,愈合良好,值得临床推广应用。     

纳米银医用抗菌敷料在深Ⅱ度烧伤患者治疗中的应用

目的探讨应用纳米银医用抗菌敷料治疗深Ⅱ度烧伤的治疗效果。方法将86例1~75岁的深Ⅱ度烧伤患者分为两组,每组各43例,对照组常规换药,以凡士林纱布外敷,观察组应用纳米银医用抗菌敷料创面换药,观察干预后两组患者创面愈合的时间、患者换药的感受、创面愈合的质量。结果 86例烧伤患者全部治愈,治疗组与对照组比较,平均愈合时间减少,换药时疼痛评分降低,创面愈合质量评分降低,P0.05,有统计学意义。结论应用纳米银医用抗菌敷料治疗深二度烧伤可缩短治愈时间,减轻患者换药的痛苦,提高创面愈合质量,是一种治疗深Ⅱ度烧伤理想的外用敷料。     

痊愈妥敷料在 PICC 穿刺点局部感染中的应用

目的：探讨痊愈妥敷料在PICC穿刺点局部感染中的应用效果。方法选取初次行PICC患者78例,按患者发病时间编号将患者分为观察组39例和对照组39例,观察组采用痊愈妥敷料外敷穿刺点;对照组采用红霉素纱布块外敷穿刺点,比较两组患者穿刺点痊愈时间。结果观察组患者痊愈时间（7．28±2．2）d,对照组为（10．21±2．8）d,两组比较差异有统计学意义（t＝5．14,P＜0．01）。结论应用痊愈妥敷料可缩短PICC穿刺点感染痊愈时间,是治疗PICC局部感染简单有效的方法。     

牛羊膜联合应用rb-bFGF对Ⅱ度烧伤创面的疗效

目的观察牛羊膜覆盖烧伤创面联合应用牛碱性成纤维细胞生长因子（rb-bFGF）对烧伤创面的临床治疗效果。方法选择以Ⅱ度烧伤创面为主的中小面积热力烧伤病人43例,试验创面面积为1%～2%。将每例病人相同性质的创面等分为3份,分别应用有孔牛羊膜（治疗组）、牛羊膜（对照组1）、凡士林油纱布（对照组2）覆盖烧伤创面,3组均联合应用rb-bFGF。结果治疗组与对照组1和对照组2相比,以深Ⅱ度烧伤创面为主的病人的创面愈合时间明显缩短（F=25.36,q=7.25、3.46,P〈0.01）;在治疗以浅Ⅱ度烧伤创面为主的病人过程中,治疗组与对照组2相比创面愈合时间明显缩短（F=12.29,q=5.21,P〈0.01）,而与对照组1相比没有明显差别（q=2.60,P〉0.05）。结论有孔牛羊膜覆盖烧伤创面及联合应用rb-bFGF能加速烧伤创面的愈合。     

藻酸钙敷料用于鼻腔填塞的效果观察

目的 :为观察藻酸钙敷料填塞手术鼻腔的治疗效果。方法 :采用随机分组 ,观察组用藻酸钙敷料填塞手术鼻腔 ,对照组用凡士林纱条填塞鼻腔。鼻部手术后 2 4h抽出填塞物 ,观察两组出血、鼻黏膜水肿、鼻部疼痛和再次行鼻腔填塞情况。结果 :观察组疗效明显优于对照组(P <0 .0 0 1)。结论 :鼻部手术后用藻酸钙敷料填塞鼻腔能提高疗效 ,减轻病人痛苦 ,减少并发症     

苯扎氯铵溶液联合藻酸钙敷料治疗老年糖尿病患者足部病变的效果

目的探讨苯扎氯铵溶液联合藻酸钙敷料应用于老年糖尿病患者足部病变的治疗与护理效果。方法便利抽样法选择2009年1月至2011年9月在解放军总医院住院的老年糖尿病足部病变患者62例,采用随机数字表法将其分为对照组和观察组各31例,对照组采用常规聚维酮碘消毒后使用硫酸庆大霉素加入小剂量普通胰岛素冲洗伤口、纱球隔离、纱布包扎的方法;观察组则在对照组的基础上增加使用苯扎氯铵溶液足部浸泡5～10min,再用藻酸钙敷料隔离覆盖伤口。观察两组患者足部伤口的愈合时间、愈合效果、护理换药耗时等,并比较患者对糖尿病足护理的满意度。结果两组患者足部伤口的愈合时间、愈合效果、换药耗时以及患者对糖尿病足护理满意度比较,差异均有统计学意义(均P<0.01)。结论苯扎氯铵溶液联合藻酸钙敷料应用于老年糖尿病患者的早期足部病变,能有效缩短足部伤口愈合时间、提高伤口愈合效果、减少护理人员换药总耗时,并明显提高患者的满意度,是适宜老年糖尿病患者足部病变的良好换药方法。     

藻酸钙敷料在肛瘘术后的应用效果观察

目的:探讨藻酸钙敷料用于肛瘘术后的临床疗效。方法:将60例肛瘘术后病人随机分为治疗组(藻酸钙敷料换药)和对照组(传统换药)。结果:藻酸钙敷料在减轻病人疼痛,减少切口分泌物,促进切口愈合等方面均明显优于传统换药方法。结论:藻酸钙敷料作为一种新型换药材料,临床疗效肯定,具有一定的应用价值。     

Prospective clinical study of Hydron, a synthetic dressing, in delivery of an antimicrobial drug to second-degree burns

This clinical trial prospectively evaluates the potential beneficial effects of antimicrobial drug delivery from a synthetic dressing (Hydron-AgSD) formed on second-degree burn wounds. A paste composed of polyethylene glycol-400, poly 2-OH ethylmethacrylate, and silver sulfadiazine (AgSD 1%-3%) matured within one hour to form a solid dressing. In 27 patients, comparable areas of second-degree wounds on the same patient were selected at random for test and control (silver sulfadiazine 1% only) sites. The mean total time of the synthetic dressing application per patient was about nine days, and each dressing remained in place for nearly four days. During this interval the control sites required four dressings changes. In 17 tests for infections, the control areas were contaminated but no bacteria were detected under the synthetic dressing; in three tests, the controls had no bacteria, whereas the synthetic dressing did. Healing of burns was similar under both types of dressing. Benefits of Hydron treatment included increased patient comfort because of the reduced number of dressing changes and, in some cases, greater freedom from contaminating bacteria.     

重组人表皮生长因子凝胶在浅Ⅱ度烧伤创面护理中的应用

目的观察重组人表皮生长因子凝胶在浅Ⅱ度烧伤创面护理中的应用效果。方法选择50例浅Ⅱ度烧伤患者,采用同体对照法,将同一创面不同区域或同体对称部位的创面分为观察组和对照组。观察组采用重组人表皮生长因子凝胶加医用硅酮凝胶膏混合后湿敷创面;对照组采用医用硅酮凝胶膏湿敷创面。观察两组创面愈合时间、换药次数、疼痛状况及渗液情况的差异。结果观察组的创面平均愈合时间（8．6±1．6）d较对照组（11．8±1．7）d明显缩短,差异有统计学意义（t=-9．834,P〈0．05）。观察组换药次数（4．5±0．9）次较对照组（6．1-I-0．9）次明显减少,差异有统计学意义（t=-9．336,P〈0．05）。两组患者的换药疼痛程度相似,差异无统计学意义（x^2=0．272,P〉0．05）。两组在第2次换药时的渗液程度相似,差异无统计学意义（x^2=0．205,P〉0．05）;而在第3和4次换药时,观察组渗液程度较对照组明显改善,差异有统计学意义（x2分别为8．988,5．316;P〈0．05）。结论重组人表皮生长因子凝胶能减少浅Ⅱ度烧伤创面的渗液量,减少换药次数,可明显促进表皮生长,加速创面愈合。     

酸性氧化电位水对烧伤深Ⅱ度创面和感染创面杀菌的作用

目的观察酸性氧化电位水（EOW）对烧伤深Ⅱ度创面和感染创面杀菌的作用。方法烧伤深Ⅱ度创面（A组）和烧伤感染创面（B组）各20例,EOW用于2组换药时的创面冲洗,A、B组分别选取同～患者相对部位、相同类型创面以生理盐水冲洗作为对照1组和对照2组。在创面处理前（T0）及处理后的第1、4及7天（T1,T4,T,）对创面进行涂抹采样,棉拭采样端接种实验细菌进行培养（37℃培养48h）,计算各组创面菌落数,并比较处理后菌落数下降的幅度。结果处理后,各组烧伤创面菌落计数均明显减少（P〈O．01）,随处理时间的延长菌落数的差值逐渐增大（P〈0．01）,呈时间依赖性;A、B组创面菌落数减少的幅度分别大于对照l、2组（P〈O．01）。结论EOW对烧伤深Ⅱ度创面和感染创面杀菌作用优于生理盐水。     

Green preparation of anti-inflammation an injectable 3D porous hydrogel for speeding up deep second-degree scald wound healing

Scalds are one of the most common injuries and the 4th cause of trauma globally. Alginate has emerged as a promising scald wound dressing. Herein, we present a facile applicable strategy for electron beam (EB) radiation crosslinking gelatin, alginate, and carboxymethyl cellulose (CMC) into an injectable three-dimensional (3D) porous hydrogel (3D-PH) with a double crosslinked network for reliable deep second-degree scald wound healing. In addition, the injectable 3D-PH stimulated proliferation and migration of dermal fibroblasts in vitro and the deep second-degree scald wound healing process is accelerated in vivo. Most importantly, in vitro results revealed that the injectable 3D-PH stimulated cell proliferation via inducing the expression of Ki-67, and suppressed inflammatory signals as indicated by the downregulation of inflammatory factors (IL-6, TNF-α) in L929 cells. We further demonstrated that the 3D-PGH accelerated the wound healing process of deep second-degree scald in vivo. This study indicated the injectable 3D-PH with a double crosslinked network could be applied as a multifunctional injectable scald wound dressing material for anti-inflammation, necrotic tissue-removal, and wound closure. These findings suggest that the injectable 3D-PH may be conducive to the evolution of new pharmaceuticals for burn wound healing.

The injectable 3D porous hydrogel with a double crosslinked network could be applied as a multifunctional injectable scald wound dressing material for anti-inflammation, necrotic tissue-removal, and wound closure.     

气管切开造口处蝶形透明敷料的临床应用

目的 探讨蝶形透明敷料用于气管切开造口处的效果.方法 随机选取急性呼吸衰竭气管切开患者62例,随机分为观察组32例和对照组30例,观察组采用蝶形透明敷料覆盖,对照组采取白色医用胶布覆盖造口.对比观察2组患者拔管后无创通气、耐受情况,造口处局部皮肤反应及平均愈合时间.结果 观察组患者耐受性明显高于对照组.局部不良反应明显低于对照组,且平均愈合时间缩短.结论 蝶形透明敷料是一种气管切开造口处良好的敷料.     

Effectiveness of Jaw Relaxation for Burn Dressing Pain: Randomized Clinical Trial

Patients hospitalized for burn injuries experience severe pain, both immediately after the injury and during daily therapeutic procedures such as dressing changes. Relaxation is increasingly suggested as a pain control technique that can be used by nurses in daily practice. Yet the effects of relaxation on burn pain are not clear. The aim of this study was to investigate whether jaw relaxation will decrease pain intensity of burn dressing. Accordingly, a randomized clinical trial (n = 100) was conducted between 2009 and 2010 to compare jaw relaxation and usual care. Consenting patients were randomly assigned to either experimental or control groups using minimization. The experimental group practiced jaw relaxation for 20 minutes before entering the dressing room. Data were collected by visual analog scale (VAS), and several structured questions were asked of the experimental group. No significant difference was seen between mean pain intensity scores in the experimental and control groups after dressing (p = .676). Regarding the ineffectiveness of jaw relaxation for pain intensity of burn dressing, future studies are suggested to concentrate on longer durations of relaxation time and continuing the procedure in dressing room. Simultaneous study of the effect of this technique on residual, breakthrough, and procedural burn pain is also recommended.