壳聚糖止血敷料用于永久性心脏起搏器植入术后的效果观察

目的探讨永久性心脏起搏器植入术后应用壳聚糖止血敷料促进伤口愈合的效果。方法选择航天中心医院行永久性心脏起搏器植入术的患者200例，完全随机分为试验组和对照组，各100例。术后当日及后续隔日换药时试验组和对照组分别使用壳聚糖止血敷料涂抹及传统消毒换药方法，评估手术切口愈合情况。结果试验组及对照组甲级愈合率分别为98％和82％（P=0．001），其余均为乙级愈合。对照组有1例术后切口出血，1例囊袋血肿，试验组无手术并发症。多元回归分析显示，试验组手术切口甲级愈合情况与年龄、体重指数、平均血压、血小板计数、国际标准化比值、糖化血红蛋白均元明显关系（r=0．23，P=0．534；r=0．12，P=0．299；r=0．35，P=0．635；r=0．29，P=0．612；r=0．22，P=0．134；r=0．38，P=0．527），对照组甲级愈合情况与糖化血红蛋白比值正相关（r=0．72，P=0．044）。结论壳聚糖止血敷料可以明显促进起搏器切口愈合，减少手术并发症。

Effect of chitosan hemostatic dressings on permanent cardiac pacemaker implantation

Objective To discuss effect of chitosan hemostatic dressings on wound healing after permanent pacemaker implantation. Methods Totally 200 patients with permanent cardiac pacemaker implantation were ran- domly divided into test group and control group; each group had 100 cases. For every other day the chitosan dress- ings was used. Results The number （ratio） of grade A healing cases in test group and control group were 98 （98%） and 82 （82%） （P =0. 001 ） ; others were grade B healing. There was one patient who had postoperative wound bleeding and one patient had pocket hematoma in control group. There was no complication in test group. Multiple regression analysis showed that the grade A ratio of wound healing in test group was related with average age, body mass index, blood pressure, glycosylated hemoglobin, platelet count and international standardization. Grade A ratio was related to glycosylated hemoglobin in the control group. Conclusion Chitosan bemostatic dress- in~s can ~reatlv promote the pacemaker wound healing and reduce complications.