摘要
目的探讨临床常用的烧伤抑菌霜和纳米银抗菌凝胶对铜绿假单胞菌感染深Ⅱ度烧伤创面的效果,为门诊确定换药方案提供依据。方法实验用54只SD雄性大鼠,在SD大鼠背部建立两个一致的铜绿假单胞菌感染的深Ⅱ度烧伤创面后,随机平均分为3组,A组采用烧伤抑菌霜、B组采用纳米银抗菌凝胶和C组采用空白无菌纱布进行换药,记录换药后创面组织细菌含量的降低值和创面愈合过程中收缩率、上皮化率和创面愈合时间,数据采用SPSS19.0统计软件进行处理。结果换药前后3组SD大鼠创面的细菌定量差值差异明显,A组创面换药前后差值最大为(1.67±0.294)×108 CFU/g,抑菌率最高为(83.46±1.38)%,差异有统计学意义(P<0.05);烫伤后早期两组创面的收缩率差异无统计学意义,随着换药次数的增加,两组之间的差异逐渐增大,在创面愈合后期,创面收缩率之间的差异又逐渐缩小;在烫伤第16天B组创面的上皮化率(94.84±3.34)%,明显快于A组(78.99±6.56)%和C组(64.88±5.78)%,差异有统计学意义(P<0.05),A组上皮化率快于C组,差异有统计学意义(P<0.05);B组创面愈合时间最短(16.88±0.834)d,A组次之(20.50±1.195)d,C组时间最长(25.88±2.100)d,3组创面愈合时间比较,差异有统计学意义(P<0.05)。结论这两种新型银制剂在抗菌能力和促进创面愈合上均有较好的效果,但是效果各有差异,为较好的管理烧伤创面,可推荐联合使用,早期使用烧伤抑菌霜预防治疗创面感染可达到较好的抗菌效果,中后期为促进创面上皮化改用纳米银抗菌凝胶的效果更好。
OBJECTIVE To observe the effects of the most commonly used silver agents such as aid antibacterial cream and SilverCare nano-silver antibacterial gel on the Pseudomonas aeruginosa wound infection in the deep Ⅱdegree burn patients so as to provide guidance for drug dressing in outpatient department .METHODS Totally 54 Sprague-Dawley （SD） rats with two consistent deep second degree burn were infected with P .aeruginosa on the back , the rats were randomly divided into three groups , the group A received BangerkangTM Burn-aid antibacterial cream ,the group B received SilverCare nano-silver antibacterial gel ,and the group C received nothing as the control group via the conventional dressing method .The reduction in content of bacteria in the burned tissues after drug dressing ,the contraction rate during the wound healing ,the epithelialization rate ,and the time of wound healing were recorded;the data were statistically analyzed by using SPSS19 .0 software .RESULTS There was significant difference in the bacterial quantitative difference between the three groups of SD rats before and after drug dressing ,the group A has the greatest difference （1 .67 ± 0 .294） × 10^8 CFU/g and the highest bacterial inhibition rate （83 .46 ± 1 .38 ）% , there was statistically significant difference （ P〈 0 .05 ） . There was no statistically significant difference in the contraction rate of wound in the early stage of burn between the two groups;with the increase of frequency of drug dressing ,the difference became greater and greater ;the difference in the contraction rate of wound narrowed in the late stage of wound healing .The epithelialization rate of the group B was （94 .84 ± 3 .34）% on day 16 of the burn wound ,significantly higher than （78 .99 ± 6 .56）% of the group A and （64 .88 ± 5 .78）% of the group C ,there was statistically significant difference （P〈 0 .05）;the epithelialization rate of the group A was higher than that of the group C ,with significant difference （P〈0 .05） . The time of wound healing was the shortest in the group B （16 .88 ± 0 .834）days ,followed by the group A （20 .50 ± 1 .195）days and the group C （25 .88 ± 2 .100）days ,there was statistically significant difference in the time of wound healing between the three groups （P〈0 .05） .CONCLUSIONS Both of the novel silver agents can achieve good effects on the antibacterial activity and promotion of wound healing but differ in the effects ;the combined drug therapy is recommended for the management of the burn wound ,the BangerkangTM Burn-aid antibacterial cream will achieve a better effect on prevention of wound infections in the early stage ,and the SilverCare nano-silver antibacterial gel can achieve better effect on promotion of wound epithelialization in the middle and late stage .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第20期5107-5109,共3页
Chinese Journal of Nosocomiology
基金
国家自然科学基金资助项目(30872155)
国家科技重大专项基金资助项目(2013ZX 10004805-003)
全军医学科技"十二五"科研基金资助项目(AWS11L009
11BJZ01)
关键词
铜绿假单胞菌
创面感染
抗菌能力
创面收缩率
创面上皮化率
Pseudomonas aeruginosa
Wound infection
Antibacterial ability
Wound contraction rate
Wound epithelialization rate
