抗菌敷料联合VSD术治疗慢性感染性创面不愈合的临床效果

目的观察抗菌敷料联合负压封闭引流(VSD)术对慢性感染性创面不愈合患者引流液细菌分布、血液炎性指标的影响。方法选取义乌復元私立医院100例慢性感染性创面不愈合患者,随机分为两组,各50例,对照组予以VSD术治疗,研究组在其基础上加用抗菌敷料,比较两组治疗前后引流液病原菌阳性率与细菌分布、血液炎性指标白细胞计数(WBC)、C-反应蛋白(CRP)、中性粒细胞百分比(NEUT%)、淀粉样蛋白A(SAA)]、疼痛数字评分法(NRS)评分、创面愈合率、感染控制时间、创面愈合时间。结果研究组治疗后3、7 d引流液病原菌阳性率低于对照组(P<0.05);研究组治疗后3 d与7 d引流液细菌数目与细菌种类均少于对照组,对照组随时间推移细菌数目增加,而研究组细菌数目与种类均减少;研究组治疗后7 d WBC、CRP、NEUT%、SAA水平均低于对照组(P<0.05);研究组治疗后7 d NRS评分低于对照组(P<0.05);研究组治疗第20天与第30天创面愈合率高于对照组(P<0.05);研究组感染控制时间与创面愈合时间短于对照组(P<0.05)。结论抗菌敷料联合VSD术治疗慢性感染性创面不愈合患者,可有效减少引流液细菌数目与种类,降低细菌阳性率,促进机体炎症与疼痛症状好转,缩短创面愈合进程。

Clinical effect of antibacterial dressing combined with VSD on treatment of patients with unhealing chronic infectious wound

OBJECTIVE To observe the effect of antibacterial dressing combined with vacuum sealing drainage(VSD)on drainage fluid bacteria and serum inflammatory indexes of the patients with unhealing chronic infectious wound.METHODS A total of 100 patients with unhealing chronic infectious wound who were treated in Yiwu Fuyuan Hospital Co.,Ltd were enrolled in the study and randomly divided into two groups,with 50 cases in each group.The control group was treated with VSD,while the study group was treated with additional antibacterial dressing on the basis of the treatment of the control group.The positive rate of pathogens in drainage fluid,distribution of pathogens,serum inflammatory indexeswhite blood cell count(WBC),C-reactive protein(CRP),neutrophil percentage(NEUT%),amyloid A(SAA)],pain numerical rating scale(NRS)score,wound healing rate,infection control time and wound healing time were observed and compared between the two groups of patients before and after the treatment.RESULTS The positive rates of pathogens in drainage fluid were significantly lower in the study group than in the control group after the treatment for 3 and 7 days(P<0.05).The bacterial colony counts and species of pathogens in drainage fluid were significantly less in the study group than in the control group after the treatment for 3 and 7 days,the bacterial colony counts of the control group were significantly increased with the time,while the bacterial colony counts and species of pathogens of the study group were significantly decreased.The levels of WBC,CRP,NEUT%and SAA of the study group were significantly lower than those of the control group after the treatment for 7 days(P<0.05).The NRS score of the study group was significantly lower than that of the control group after the treatment for 7 days(P<0.05).The wound healing rates of the study group were significantly higher than those of the control group after the treatment for 20 and 30 days(P<0.05).The infection control time and wound healing time of the study group were significantly shorter than those of the control group(P<0.05).CONCLUSION The antibacterial dressing combined with VSD can effectively reduce the bacterial colony counts and species of pathogens in drainage fluid,lower the positive rate of pathogens,promote the recovery from inflammation and pain,and shorten the wound healing process.