摘要
目的探讨藻酸盐银离子敷料在会阴部急性坏死性筋膜炎(NF)清创术后创面处理中的应用效果。方法回顾性分析本院2013年1月至2018年1月收治的患者38例会阴部急性NF患者的临床资料,患者均行常规清创术,根据术后创面处理方法不同分为观察组和对照组,其中2013年1月至2015年12月收治的18例患者为对照组,术后使用碘伏溶液清洁创面并覆盖碘伏溶液纱布;2016年1月至2018年1月收治的20例患者为观察组,术后以藻酸盐银离子敷料填塞处理伤口。比较两组创面疼痛和创面愈合情况,比较两组术前及术后第1、3、7 d白细胞计数(WBC)、中性粒细胞占比(N)、淋巴细胞占比(L)、C反应蛋白(CRP)、白细胞介素4(IL-4)、白细胞介素6(IL-6)水平。结果观察组术后第3、7、14 d创面疼痛均轻于对照组,创面愈合时间短于对照组,上述差异均有统计学意义(均P <0.05)。观察组术后3 d、7 d WBC、N、L、CRP、IL-6均低于对照组,IL-4高于对照组,差异均有统计学意义(均P <0.05)。结论会阴部急性NF清创术后采用藻酸盐银离子敷料进行切口换药,可减轻患者疼痛和全身炎症反应,促进创面愈合,具有良好的应用价值。
Objective To investigate the effect of alginate ion silver dressing on wound healing after perianal acute necrotizing fasciitis(NF)debridement.Methods Clinical data of 38 patients with perianal acute NF admitted to our hospital from August 2013 to August 2018 were respectively analyzed.All patients received routine debridements.According to different postoperative wound treatment,all patients were divided into observation group and control group,among which,18 patients admitted to the control group from January 2013 to December 2015 were treated with iodophor solution to clean the wound and covered with iodophor solution gauze;20 patients admitted to the observation group from January 2016 to January 2018 received a replacement with an alginate silver ion dressing after operation.The wound pain and wound healing effect in the two groups were compared.Meanwhile,white blood count(WBC),neutrophil percentage(N),lymphocyte percentage(L),C-reactive protein(CRP),interleukin-4(IL-4)and interleukin-6(IL-6)levels of preoperative and 1,3 and 7 days after operation were compared between the two groups.Results The wound pain of 3,7 and 14 day after operation in the observation group were significantly lighter than those in the control group,and the healing time of the wound was significantly shorter than that in the control group(P<0.05).WBC,N,L,CRP and IL-6 at 3 and 7 days after operation in the observation group were significantly lower than those in the control group,and IL-4 was significantly higher than that in the control group(P<0.05).Conclusion Silver alginate dressing can reduce pain and inflammation of the body,and also can promote wound healing after perianal acute NF debridement,which has a good application value.
作者
马辉
班翠珍
廖存
李丽
韦瑞丽
Ma Hui;Ban Cuizhen;Liao Cun;Li Li;Wei Ruili(Department of Colorectal and Anorectal Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi,530021,China)
出处
《结直肠肛门外科》
2018年第6期594-599,共6页
Journal of Colorectal & Anal Surgery
关键词
急性坏死性筋膜炎
创面愈合
藻酸盐银离子敷料
炎性反应
acute necrotizing fasciitis
wound healing
alginate ion silver dressing
inflammatory response
