目的 观察磺胺嘧啶银混悬液治疗烧伤创面患者的疗效。方法 选择2015-01至2017-10我科收治的172例烧伤患者,所有患者创面均符合Ⅱ度烧伤临床诊断标准,患者均为伤后24 h入院。将患者随机分为两组,分别给予外涂磺胺嘧啶银混悬液(磺胺嘧啶银组)和京万红(京万红组)治疗。治疗后第1、7、14、21天分别留取细菌学培养,观察两组患者创面愈合时间、创面细菌转阴率、抗生素使用时间并进行比较。结果 (1)磺胺嘧啶银组:浅二度创面在伤后10～12 d痊愈,平均愈合时间(11.8±2.3)d,深二度创面愈合时间为19～28 d,平均愈合时间为(23.5±3.2)d,抗生素使用时间均为7 d。(2)京万红组:26例发生创面感染、创周红肿;7例深二度创面加深,后期植皮愈合。除7例创面感染植皮愈合患者,其他患者浅二度创面平均愈合时间为(14.1±2.4)d,深二度创面平均愈合时间(27.8±3.5)d,平均抗生素使用时间(10.8±0.6)d。磺胺嘧啶银混悬液组创面细菌数量、抗生素使用时间及创面愈合时间明显低于京万红组,差异有统计学意义(P<0.05)。结论 磺胺嘧啶银混悬液较京万红能增加抗感染能力,减少创面细菌数量,有利于创面愈合,值得推广。
Abstract
Objective To observe the curative effect of sulfadiazine silver suspension in the treatment of burn wounds.Methods One hundred and seventy-two burn patients were selected between January 2015 and October 2017, whose wounds met the clinical diagnostic criteria for second degree burns.The patients were admitted 24 hours after injury and were randomly divided into two groups that were respectively treated with sulfadiazine silver suspension and Jingwanhong after hospitalization. Meanwhile, bacteriological culture was taken to observe the healing time of the wounds, the bacterial negative rate, and the duration of antibiotic use in the two groups.Results In the sulfadiazine silver suspension group,the shallow second degree burns were all healed within 10 to 12 days after injury, with an average healing time of (11.8±2.3) days, while the deep second degree burns healed in 19 to 28 days, with an average healing time of (23.5±3.2 )days.Antibiotics were used for an average of 7 days.In the Jingwanhong group, 26 patients had wound infections and wound redness. Deep second degree wounds deepened in 7 cases but healed after skin graft. Excluding the 7 cases of wound infections that were cured after skin graft, the average healing time of shallow second wounds was (14.1±2.4)days, compared with(27.8±3.5)days for deep second wounds. The average duration of antibiotic use was (10.8±0.6)days.The number of bacteria in the wound, the duration of antibiotic use and the time taken by wound healing were significantly smaller or shorter than those of patients treated with Jingwanhong.Conclusions Compared with Jingwanhong, sulfadiazine silver suspension can significantly increase the anti infection effect, reduce the number of bacteria in the wound, and facilitae the healing of wounds, which is worthy of wider application.
关键词
磺胺嘧啶银混悬液 /
二度烧伤 /
抗感染
Key words
SD-Ag /
second degree burn /
anti-infection
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Norbury W,Herndon D N,Tanksley J,et al.Infection in burns[J].Surg Infect,2016,17(2):250-255.
[2] Susethirs A R,Uma A,Prabhu N,et al.Management of met hicillin resisitant Staphyiococcus aureus infection of endogenous origin in an electrical burns patient-a case report[J].Br Microbiol Res J,2014,4(10):1138.
[3] Dai T,Gupts A,Huang Y Y,et al.Blue light rescues mice from potentially fatal Pseudomonas seruginosa burn in fection:efficacy,safety,and mechanis of action[J].Antimicrob Agents Chemother,2013,57(3):1238-1245.
[4] 吴在德.外科学[M] .6版,北京:人民卫生出版社,2003:195-20l.
[5] 高明娟,李 娟,王晓娜,等.50%TBSA Ⅲ度烧伤犬静脉补液时丙酮酸钠林格液对循环血容量和血乳酸水平的影响[J].武警医学,2016,27(1):51-54.
[6] 张文浩,周莉萍,张志华,等.扩创植皮联合负压封闭引流治疗烧伤患者后期感染难愈创面[J].中华烧伤杂志,2014,30(4):365-367.
[7] 雷 芳,唐有玲,陈 佩,等.运动疗法联合自制简易矫形器治疗儿童手部烧伤瘢痕挛缩的疗效观察[J].中华烧伤杂志,2014,30(6):477-481.
[8] 孟素玉,赵 鹏,马雅宁,等.磺胺嘧啶银锌霜联合莫匹罗星治疗烧伤创面局部感染的有效性研究[J].当代医学,2016,22(34):165-166.
[9] 邓忠远.rhGM-CSF 联合磺胺嘧啶银治疗深Ⅱ度烧烫伤创面的临床研究[J].医学临床研究,2017,34 (5):932-934.
[10] 龚振华,姚 建,季建峰,等.银离子敷料联合水凝胶对Ⅱ度烧伤创面愈合的作用[J].中国组织工程研究与临床康复,2009,13(42):8373-8376.
[11] Cencetti C,Bekkini D,Pavesio A,et al.Preparation and characterization of antimicrobial wound dressings based on silver.gellan.PVA and borax[J].Carbohydr Polym,2012,90(3):1362-1370.
[12] Percival S L.Thomas J G,Slone W,et al.The efficacy of silver dressings and antibiotice on MRSA and MSSA isolated from burn patients [J].Wound Repair Regen,2011,19(6):767-774.
[13] Mohseni M, Shamloo A, Aghababaei Z, et al. Antimicrobial wound dressing containing silver sulfadiazine with high biocompatibility: in vitro study [J]. Artif Organs, 2016, 40(8): 765-773.
[14] Black J S, Drake D B. A prospective randomized trial comparing silver sulfadiazine cream with a water-soluble polyantimicrobial gel in partial-thickness burn wounds [J]. Plast Surg Nurs, 2015, 35(1): 46-49.
[15] 张 媛. 纳米银与磺胺嘧啶银治疗烧伤创面的临床疗效对比[J].今日健康,2016,15(10):163.
PDF(575 KB)
