莫匹罗星纱条对肛瘘术后创面愈合的临床观察

目的:观察莫匹罗星纱条对肛瘘术后创面的疗效。方法:选取江西中医药大学附属医院60例低位单纯性肛瘘术后患者,随机分为治疗组和对照组各30例,两组均在术后第2天开始换药。治疗组以莫匹罗星纱条换药,对照组用雷夫诺尔纱条换药。比较两组术后创面疼痛程度、创面愈合面积、创面愈合时间的差异。结果:治疗组术后创面疼痛程度、创面愈合面积以及创面愈合时间均明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论:莫匹罗星纱条促进肛瘘术后创面愈合有一定的临床价值,值得推广。     

自制莫匹罗星纱条对肛瘘术后创面愈合的临床观察

【摘要】 目的 观察莫匹罗星纱条对肛瘘术后创面的疗效。 方法 选取我院60例低位单纯性肛瘘术后患者,随机分为治疗组和对照组各30例,两组均在术后第二天开始换药。治疗组以莫匹罗星纱条换药,对照组用雷夫诺尔纱条换药。比较两组术后创面疼痛程度、创面愈合面积、创面愈合时间的差异。 结果 治疗组术后创面疼痛程度、创面愈合面积以及创面愈合时间均明显优于对照组,具有显著性差异。(P＜0.05) 结论 莫匹罗星纱条促进肛瘘术后创面愈合有一定的临床价值,值得推广。     

莫匹罗星联合呋喃西林治疗脓疱疮疗效观察

目的:评价莫匹罗星联合呋喃西林治疗脓疱疮疗效及安全性。方法:将67例脓疱疮患者随机分为2组,实验组以莫匹罗星涂患处,且皮损较大处应用呋喃西林溶液湿敷;对照组以红霉素软膏以及碘伏涂患处,3次/d,疗程均1w。结果:实验组与对照组总有效率分别为97.22%、69.69%;痊愈率分别为88.89%、39.39%。经统计学处理,总有效率相比χ2=9.7344(P<0105);痊愈率相比χ2=19.1(P<0101),两者间差异均有统计学意义。结论:莫匹罗星联合呋喃西林治疗脓疱疮疗效确切,且比较安全。     

莫匹罗星软膏治疗感染性皮肤病40例疗效观察

我院2003-01～2003-12使用中美天津史克制药有限公司生产的2%莫匹罗星（又名百多邦）软膏治疗感染性皮肤病40例,效果满意,现报告如下.     

莫匹罗星软膏治疗褥疮的疗效观察

褥疮是长期卧床病人，特别是老年、昏迷、瘫痪、慢性消耗性疾病的常见并发症。近4年来，我们采用莫匹罗星软膏(mupirocin ointment)，又称(百多邦软膏)治疗褥疮，取得了较好的效果。现将观察结果报告如下。     

预防性外用莫匹罗星对于腹膜透析患者导管出口评分的影响

目的探讨用出口评分（Exit-Site Score,ESS）法评分进行腹膜透析（CAPD）导管出口感染的辅助诊断,观察莫匹罗星治疗对于出口评分的影响。方法选取在上海交通大学附属第一人民医院肾内科行腹膜透析的80例患者,运用横断面调查的方法,采用腹膜透析患者出口评分法来进行评分。对于ESS2～3分者,随机分成两组,一组予以常规的每日清洁,另一组在此基础上进行每日在出口处涂擦莫匹罗星乳膏1个月,再次进行相关的评分。然后对于所有的ESS评分为2～3分的糖尿病患者以及浅表涤纶套距离皮肤较近者（〈1.5cm）,皆采用每日在出口处涂擦莫匹罗星乳膏,累计1个月的治疗,观察其后ESS评分的改善。结果①80例患者中,ESS评分≥4分者有3例,占3%;2～3分者有21例,占26%;ESS评分为0分者40例,占50%,2～3分者平均的评分为（2.7±0.6）分;②治疗组出口处评分经过一个月的治疗,ESS评分≥4分者有1例,以后发展到腹膜炎;2～3分者平均的评分为（2.2±0.5）分,较治疗前明显改善,P〈0.05。与对照组相比,治疗组的ESS评分明显改善,而对照组与治疗前评分无明显的差异;③糖尿病患者与浅表涤纶套离开皮肤较近者（1．5cm）,其ESS评分明显升高,而经过使用抗生素乳膏,ESS评分皆能获得改善。结论本研究提示对ESS评分≥2分者进行莫匹罗星治疗可以明显改善出口评分状况,从而可能影响其腹膜炎的发生。     

莫匹罗星软膏预防化疗患者颈内静脉置管感染的效果

目的探讨莫匹罗星软膏预防化疗患者颈内静脉置管感染的效果。方法便利抽样法选择2013年1-9月在湖州市中医院进行颈内静脉置管化疗的患者202例为研究对象,按其入院先后将其分为对照组和观察组,每组101例。对照组患者于常规聚维酮碘消毒待干后采用3M无菌透明敷贴敷盖穿刺点;莫匹罗星软膏组则采用聚维酮碘消毒皮肤待干后,用消毒棉签取少量莫匹罗星软膏涂抹在颈内静脉置管穿刺点处,待干后再用3M无菌透明敷贴敷盖穿刺点。比较两组患者颈内静脉置管的发生率、穿刺点周围皮肤阳性反应率及置管保留时间。结果观察组患者颈内静脉置管感染的发生率及穿刺点周围皮肤阳性反应率均低于对照组患者,差异有统计学意义(均P0.01);颈内静脉置管的留置时间比对照组长,差异有统计学意义(P0.01)。结论应用莫匹罗星软膏可预防化疗患者颈内静脉置管感染,延长留置时间。     

切口隔离预防腹部切口感染

目的 探讨切口隔离技术在预防腹部切口感染中的价值.方法 对我院近3年收治的腹部手术患者进行前瞻性研究,随机分成隔离组1300例和对照组1249例,对2组患者根据手术术式统计切口感染率,再根据切口感染主要影响因素统计切口感染率.结果 对照组和隔离组总切口感染率分别是5.9%(76/1300)和2.6%(32/1249)、切口感染率分别为胆囊切除术13.4%(40/300)和3.1%(9/280)、结肠癌根治术14.7%(24/165)和3.5%(6/159)、肠梗阻手术13.6%(15/108)和3.2%(13/114)、胃切除术9.6%(18/187)和1.8%(3/169)(P<0.01);胆道探查术9.3%(13/145)和2.9%(4/153)、WHIPPLE14.6%(8/55)和1.8%(1/56)、胆肠吻合术10.6%(9/85)和2.3%(2/88)(P<0.05);肝叶切除6.3%(6/95)和2.3%(2/86)、脾切除术5.3%(5/95)和1.2%(1/87)、门奇断流术4.6%(3/65)和1.8%(1/57)(P>0.05).Ⅰ类切口感染率对照组和隔离组分别是2.0%(6/305)和1.4%(4/280)(P>0.05);Ⅱ、Ⅲ类切口感染率7.0%(70/995)和2.9%(28/969)、老年人(≥60岁)12.6%(36/286)和3.6%(10/279)、急诊手术10.0%(38/381)和2.8%(10/362)、手术时间≥3 h 9.0%(39/435)和2.8%(12/426)、伴糖尿病14.5%(21/145)和4.9%(6/123)、伴肥胖12.3%(40/325)和3.9%(12/310)、伴营养不良8.5%(39/458)和3.2%(14/433)、伴恶性肿瘤8.6%(40/465)和3.0%(15/496)(P<0.01);择期手术4.1%(38/919)和2.5%(22/887)、年轻患者(<60岁)3.9%(40/1014)和2.3%(22/970)、手术时间<3 h 4.3%(37/865)和2.4%(20/823)、不伴糖尿病3.9%(45/1155)和2.3%(26/1126)、不伴肥胖3.7%(36/975)和2.1%(20/939)、不伴营养不良4.4%(37/842)和2.2%(18/816)、不伴恶性肿瘤4.3%(36/835)和2.3%(17/753)(P<0.05).结论 切口隔离技术能有效减少腹部手术切口污染的机会从而降低切口感染率.     

Deep sternal wound infection after cardiac surgery: Evidences and controversies

Despite many advances in prevention and perioperative care, deep sternal wound infection(DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid- and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at highrisk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy(NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a "bridge" prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors- when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate.     

Efficacy of mupirocin in methicillin-resistant Staphylococcus aureus burn wound infection.

Methicillin-resistant Staphylococcus aureus strains (MRSA) have become increasingly prevalent as nosocomial pathogens, especially in burn wounds. MRSA constituted 38% of all S. aureus isolates in our 25-bed burns unit despite the utilization of a combination of 1% silver sulfadiazine and 0.2% chlorhexidine as topical therapy. Mupirocin, a new antibiotic, has proved in vitro and in vivo to be highly effective in the treatment of MRSA infections. A prospective clinical trial with mupirocin ointment in MRSA burn wound infection was untertaken. Forty-five children with 59 discrete burn wounds and from whom MRSA were isolated were treated with 2% mupirocin ointment under occlusive dressings, applied twice daily for 5 days. The average burned area treated was 8% (range, 2 to 20%) of the total body surface area. The burn wounds were assessed clinically and bacteriologically daily. Mupirocin eliminated MRSA in all 59 wounds treated, with the maximum therapeutic response seen within 4 days. In three wounds, gram-negative organisms persisted after 5 days of topical therapy. Treatment was well tolerated by all children. We recommend that mupirocin in its present polyethylene glycol base should be used only on a selective basis, when current prophylactic topical therapy has failed to control MRSA infection in burns of less than 20% of the total body surface area, and that it should be applied only for a limited period of 5 days. The safety and the efficacy of mupirocin in burns exceeding 20% of the total body surface area need to be established.     

负压封闭引流与护理干预在骨科感染创面患者治疗中的应用

目的:探讨负压封闭引流(VSD)配合护理干预治疗骨科感染创面患者的疗效.方法:按住院号末位数字单双数将46例骨科创面感染患者随机分为观察组25例与对照组21例,对照组患者只采用VSD治疗,观察组在对照组治疗基础上予以护理干预,3个月后比较两组患者有效率、治愈时间、治愈率、住院时间及住院花费等.结果:观察组有效率为84.0%,明显高于对照组66.7%,两组比较差异有统计学意义(P<0.05);观察组患者住院(31.05±4.34)d、治愈时间(18.32±1.25)d,明显短于对照组(48.87±5.01)d,两组比较差异均有统计学意义(P＜0.05); 观察组治愈率36.0%,明显高于对照组19.0%,两组比较差异有统计学意义(P＜0.05).结论:VSD配合护理干预治疗骨科感染创面的有效率及治愈率明显优于单一VSD治疗,且能缩短治愈时间及住院时间.     

汶川地震转运伤员创面感染的特点及治疗

目的 研究汶川地震转运外省创伤伤员创面感染的特点和治疗情况.方法 对湖北省收治的84例汶川地震创伤伤员进行临床分析,统计伤员一般情况、创面感染、病原菌培养和药敏、救治效果等临床资料,并和同省其他转运伤员及未转运伤员的创面感染情况进行比较.结果 地震伤员受伤部位以体表、四肢和骨盆、头颈部为主;感染部位为四肢和骨盆4例、头面部2例、胸部1例、体表1例.四地全部送检380份病原菌,检出率为75.79％,其中G-菌占61.35％.转运伤员的混合感染率显著高于未转运伤员(36.36％比50.00％;x2=21.40,P＜0.01).全部培养中,前3位的细菌依次为大肠埃希菌56株(17.18％),阴沟肠杆菌44株(13.50％),凝固酶阴性葡萄球菌43株(13.19％),对37.06％的药物近乎完全耐药.结论 地震伤员创面感染情况受到地域、伤情、急救措施的影响,转运伤员有着较高的混合感染率和病原菌耐药率.     

Impact of prophylactic mupirocin for radical esophagectomy

The preoperative intranasal application of mupirocin significantly decreases the rate of nosocomial S. aureus infections among patients who are S. aureus carriers. However, it remains unclear whether the routine preoperative use of mupirocin would reduce postoperative S. aureus infections, especially methicillin-resistant Staphylococcus aureus (MRSA) infections, and who would benefit from the prophylactic use of mupirocin. Ninety-six consecutive patients who had undergone elective radical esophagectomy with right thoracotomy and laparotomy were evaluated. Fifty-one patients were given 2% mupirocin calcium ointment 3 times daily over 3 consecutive days before surgery. Uni- and multivariate analyses were performed to identify factors affecting the following three issues: postoperative MRSA infection, postoperative pneumonia, and the length of postoperative hospital stay. In univariate analyses, the preoperative application of mupirocin significantly reduced MRSA infection, postoperative pneumonia, and length of postoperative hospital stay. Multivariate analyses indicated significant associations between mupirocin administration and reductions in both MRSA infection and postoperative pneumonia, but not in length of postoperative hospital stay. Radical esophagectomy with right thoracotomy and laparotomy for esophageal carcinoma warranted the preoperative prophylactic administration of mupirocin in order to reduce postoperative infectious complications from MRSA. Its routine use for such a high-risk procedure is entirely reasonable.     

头孢羟氨苄对急性呼吸道感染的疗效研究

目的 :进一步观察和评价头孢羟氨苄胶囊 (赛锋 )对急性呼吸道感染的临床有效性和安全性。方法 :选择急性呼吸道感染患者 60例 ,随机分成两组 ,分别给予头孢羟氨苄胶囊和头孢克洛口服治疗 ,从临床表现及实验室检验两方面对其疗效和安全性进行对比评价。结果 :头孢羟氨苄胶囊治疗急性呼吸道感染的临床有效率为 80 % ,痰分离致病菌的药敏率 89% ,细菌清除率为 84 % ,头孢克洛则分别为 73 % ,82 % ,74 % ,差异均无显著性 ( P>0 .0 5 )。前者不良反应的发生率 ( 6% )较后者 ( 17% )低。结论 :头孢羟氨苄是一种有效而安全的治疗呼吸道轻中度急性感染的口服抗生素     

半导体激光治疗仪对外科腹部手术患者伤口治疗效果的观察

目的 探讨半导体激光治疗仪在外科腹部手术患者术后伤口治疗中的应用效果.方法 选择干部病房外科2017年8月-2019年5月收治的腹部外科手术患者204例,其中腹腔镜手术109例,达芬奇手术42例,开刀手术53例.将同类手术方式的患者按照随机数字表法分为对照组和观察组.对照组术后伤口按普外科常规消毒换药处理,观察组在此基...     

Efficacy of topical mupirocin against an experimental Staphylococcus aureus surgical wound infection

The efficacy of topically-applied mupirocin was evaluated against an experimental surgical staphylococcal wound infection in the guinea-pig. A suture impregnated with Staphylococcus aureus was inserted into a superficial wound, and topical therapy with mupirocin ointment was started 24 h after infection. In non-treated wounds, the bacterial counts increased to greater than 10(6) organisms/wound in the majority of animals at 24 h, remaining at this level for up to seven days. Therapy with placebo ointment (polyethylene glycol base) was ineffective, whereas twice daily application of mupirocin ointment resulted in elimination of the staphylococci. Mupirocin was as effective as topically-applied fusidic acid cream in reducing the bacterial counts of infected wounds.     

The impact of different methods of wound closure and dressing on the rate of wound infection in patients with fracture of the neck of femur

A prospective, pilot study was conducted to compare infection rates in four groups with different methods of wound closure and dressing among a convenience sample (n = 65) of patients with a fracture of the neck of femur. The four groups were:

Clips with Mepore dressing (n = 25)

Subcuticular suture with Mepore (n = 11)

Clips with Opsite dressing (n = 16)

Subcuticular suture with Opsite (n = 13)

There were a total of 65 participants (5 males and 60 females) with ages ranging from 70 to 103 years (mean = 86, sd = 5.7). Patients were followed during their stay on the ward. The four groups were evaluated with respect to infection rates. Gross purulent discharge, dehiscence, or purulent discharge from a single suture was considered a wound infection and this was confirmed microbiologically. Infection was noted in 6/25 (24%) of cases in which clips were used with Mepore dressing as compared to 1/11 (9%) when subcuticular sutures and Mepore were used. Infection rates for clips and Opsite, and subcuticular and Opsite were 2/16 (12.5%) and zero, respectively. Statistically there was no difference in infection rates between Mepore dressing and either type of skin closure (p = 0.4) and similarly for Opsite and either skin closure type (p = 0.48). The authors feel that the methods of wound closure and type of dressing probably have no additional benefit for the prevention of wound infection rate among elderly patients with fractures of the neck of femur, and that a larger randomized controlled study would be useful.