磺胺嘧啶银脂质水胶敷料结合负压封闭引流治疗深部感染创面的效果评价

目的：观察磺胺嘧啶银脂质水胶敷料结合负压封闭引流（VSD）治疗深部感染创面的临床效果。方法选择2010年4月-2012年12月间伤口门诊患者44例，按随机数字表法分为治疗组24例和对照组20例，治疗组采用磺胺嘧啶银脂质水胶敷料结合VSD进行治疗；对照组采用普通无菌纱布结合VSD进行治疗。比较两组患者换药时疼痛程度、相同时间点两组细菌清除率、创面清洁时间、堵管次数、换引流管的次数等指标。结果两组患者换药时的疼痛感比较，治疗组较对照组患者疼痛程度轻，差异有统计学意义（Z＝-4．036，P＜0．05）。治疗组患者的细菌清除率、创面平均清洁时间、堵管率、换引流管的次数分别为94％，12 d，0％，3．2次，明显优于对照组的73％，28 d，70％，9．1次，差异有统计学意义（χ2＝21．32，P＜0．05）。结论磺胺嘧啶银脂质水胶敷料结合VSD能提高细菌的清除率，防止引流管堵塞，减少引流管的更换次数，缩短创面的清洁时间，能减轻患者的疼痛程度，缩短患者住院时间。

Evaluation of the effect of the silver sulfadiazine lipid water gel dressings combined with VSD on treatment of deep wound infection

Objective To observe the effect of silver sulfadiazine lipid water gel dressings combined with vacuum sealing drainage （ VSD） on the treatment of deep wound infection .Methods From April 2010 to December 2012, 44 patients with wound clinic were randomly divided into treatment group （n=24） and control group （ n=20 ） .And treatment group received water gel dressing with silver sulfadiazine lipid binding VSD treatment,while control group received theordinary sterile gauze combination VSD treatment .Then, patients dressing pain , bacterial clearance rate at the same point , wound cleaning time , the number of times of plugging and times of changing drainage tube were observed .Results Pain with the treatment group was mild compared with the control group,and the difference was statistically significant （Z =-4.036, P ＆lt;0.05）.Bacterial clearance rate （94% vs 73%）, wound cleaning time （12 d vs 28 d）, plugging （0% vs 70%）, times of changing drainage tube （3.2 vs 9.1） in treatment group were significantly better than that in control group （χ2 =21.32,P＆lt;0.05）.Conclusions Silver sulfadiazine lipid water glue dressing combined with VSD can effectively improve the rate of bacterial clearance , prevent the drainage tube blockage , reduce the number of drainage tube replacement , shorten wound cleaning time , reduce the patient ’ s degree of pain , and be shorter hospital stay .