苯扎氯铵联合生肌膏对疮面细菌清除和愈合作用的临床观察

【摘要】目的观察苯扎氯铵联合生肌膏换药对老年褥疮患者疮面细菌清除和愈合作用的疗效。方法将62例老年褥疮患者随机分为试验组32例和对照组30例，试验组疮面局部应用苯扎氯铵联合生肌膏换药治疗，对照组应用碘伏联合无菌凡士林常规换药。结果62例疮面组织学标本共培养出病原菌89株，其中革兰阳性球菌、革兰阴性杆菌和真菌分别为48％、43%和9%。试验组治疗2周后疮面细菌培养阳性率与对照组无明显差异（53.1%vs73.3%,P＞0.05），治疗4周后疮面细菌培养阳性率低于对照组（23.3%vs50.0%,P＜0.05）；试验组治疗2周和4周后疮面缺损肉芽组织的体积均小于对照组（P＜0.05）。换药治疗2个月后，试验组的治愈率（71.8%）和总有效率（100%）均高于对照组（46.7%、86.7%），而不良反应的发生率（0）低于对照组（23.3%），差异有统计学意义（P＜0.05）。结论老年褥疮患者疮面局部应用苯扎氯铵和生肌膏换药，能有效杀灭疮面细菌，缩短疮面愈合时间，临床应用安全可靠。

The Clinical Observations of Benzalkonium Chloride Combined Skin-growing

Objective To discuss the effect of benzalkonium chloride combined skin-growing ointment in clearing bacteria and healing wound of elderly patients complicated bedsore. Methods 62 elderly patients complicated decubitus ulcer were randomly divided into experimental group(32 cases) and control group(30 cases), the local wound were applicated with benzalkonium chloride combined skin-growing ointment in experimental group, but in control group were routinely applicated with iodine combined aseptic vaseline. Results 89 strains pathogenic bacteria were collected in 62 cases of wound histological specimens, the cocci, bacilli and fungi accounted for 48%, 43%, and 9% respectly. 4 weeks later, the positive rate of wound bacteria culture in experimental group significantly were lower than that in control group(P<0.05), the defective granulation tissue volume were significantly lower than that in control group (P<0.05). 2 months later, the curative rate and total effective rate in experimental group were significantly higher than that in control group(P<0.05), but the incidence of aderse events were significantly lower than that in control group(P<0.05). Conclusion Applying the benzalkonium chloride combined skin-growing ointment is safe and effective in treating patients complicated decubitus ulcer, which can effectively kill bacteria and shorten wound healing time.