复方磺胺嘧啶锌凝胶在治疗下肢静脉性溃疡中的应用

目的 观察复方磺胺嘧啶锌凝胶治疗下肢静脉性溃疡的疗效.方法 选择2015年1月至2019年12月于我院就诊的下肢静脉性溃疡患者,包括尚未行手术治疗的门诊换药患者40例和手术治疗患者40例.采用随机数字表法将未手术患者随机分为未手术试验组(20例)及未手术对照组(20例),将手术治疗患者随机分为手术试验组(20例)及手术对照组(20例).试验组患者常规碘伏换药后复方磺胺嘧啶锌凝胶敷于下肢溃疡处,对照组患者常规碘伏换药后利凡诺纱布敷于下肢溃疡处.观察并比较各组患者在治疗不同时间点的溃疡面积缩小率和溃疡愈合率.结果 未手术试验组患者治疗1、2、3周时的溃疡面积缩小率均高于未手术对照组(P均＜0.01).手术试验组患者治疗1、2、3、4周时的溃疡面积缩小率与手术对照组相比,差异均无统计学意义(P均＞0.05).治疗2和4周时的溃疡愈合率手术试验组与手术对照组比较,差异均无统计学意义(P均＞0.05).未手术试验组、对照组患者治疗3周时的溃疡愈合率分别为0、5％(1/20),两组差异无统计学意义(P＞0.05).结论 复方磺胺嘧啶锌凝胶具有促进下肢静脉性溃疡愈合的作用,在尚未手术的保守治疗患者中,常规换药后复方磺胺嘧啶锌凝胶外敷的疗效优于常规换药后利凡诺外敷.

Application of compound sulfadiazine zinc gel in treating venous leg ulcers

Objective: To observe the efficacy of compound sulfadiazine zinc gel in the treatment of venous ulcers of the lower extremities. Methods: From January 2015 to December 2019, 40 patients with venous ulcer of lower extremity were selected, including 40 outpatients with dressing change and 40 surgical patients. Random number method was used to randomly divide 40 outpatients who had not undergone surgical treatment into the non-operative experimental group (n=20 cases) and the non-operative control group (n=20 cases). In the non operative group, compound sulfadiazine zinc gel was applied to the leg ulcers after routine iodophor dressing, while in the non operative group, rivanol gauze was applied to the leg ulcers after routine iodophor dressing. 40 patients undergoing vascular surgery were randomly divided into the operation experimental group (n=20 cases) and the operation control group (n=20 cases). After the operation ,the compound sulfadiazine zinc gel was applied to the leg ulcer area after routine iodophor dressing change in the experimental group. The rivanol gauze was applied to the leg ulcer area after routine iodophor dressing change in the control group.The ulcer area reduction rate and healing rate were observed. Results: The reduction rate of ulcer area in the non-surgical experimental group was significantly higher than that in the non-surgical control group at 1, 2, and 3 weeks of treatment, and the difference was statistically significant (P <0.05).The ulcer area reduction rate of the operation experimental group was slightly higher than that of the operation control group at 1, 2 and 3 weeks of treatment, but the difference was not statistically significant (P > 0.05).There was no significant difference in the healing rate between the operation experimental group and the operation control group (P > 0.05).There was no significant difference in the healing rate between the non operative experimental group and the non operative control group (P > 0.05).Conclusion: Compound sulfadiazine zinc gel has the effect of promoting the healing of venous ulcers in the lower extremities. Among patients with conservatively treated venous ulcers who have not yet undergone surgery,the effect of external application of compound sulfadiazine zinc gel after routine dressing change is better than that of rivanol after routine dressing change.