Abstract:

Objective　To study and analyze the clinical effect of silver ion antibacterial functional dressing combined with negative pressure wound therapy (NPWT) for patients with chronic infectious wounds. Methods　One hundred and fourteen patients with chronic infectious wounds who were treated in Lianyungang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from October 2017 to October 2022 were selected as the study subjects. The patients were divided into a control group and a study group by lottery, with 57 cases in each group. There were 27 women and 30 men in the control group; they were (57.12±3.76) years old; their course of disease was (30.24±4.52) d. There were 26 women and 31 men in the study group; they were (56.85±3.91) years old; their course of disease was (30.01±4.29) d. The control group were treated with NPWT, and the study group with NPWT and silver ionomer antibacterial functional dressing. The clinical efficacies, levels of inflammatory factors [hypersensitive C-reactive protein (hs-CPR), procalcitonin (PCT), and fibrinogen (FIB)], dressing change times, wound healing times, pain degrees, and wound closure indexes of the two groups were observed. The data were statistically analyzed by χ² and t tests. Results　The total clinical effective rate of the study group was higher than that of the control group [98.25% (56/57) vs. 85.96% (49/57)], with a statistical difference (χ²=4.343, P<0.05). After the treatment, the levels of hs-CRP, PCT, and FIB in the study group were lower than those in the control group [(8.41±0.85) mg/L vs. (9.25±0.89) mg/L, (0.33±0.10) μg/L vs. (0.40±0.11) μg/L, and (3.94±0.61)g/L vs. (4.42±0.66) g/L], with statistical differences (t=5.153, 3.555, and 4.032; P<0.05). The dressing change times, wound healing time, and pain degree in the study group were lower than those in the control group [(9.78±3.54) times vs. (15.34±4.34) times, (19.43±5.13)d vs. (25.67±5.51)d, and (3.89±1.34) vs. (4.76±1.51)], with statistical differences (t=7.495, 6.258, and 3.254; P<0.05). The wound closure indexes 7, 14, 21, and 28 d after the treatment in the study group were higher than those in the control group [(39.54±4.46) vs. (36.40±4.38), (56.34±3.74) vs. (54.25±3.35), (80.24±5.85) vs. (70.46±5.18), and (96.03±3.24) vs. (87.65±4.32)], with statistical differences (t=3.792, 3.143, 9.450, and 11.716; P<0.05). Conclusion　Silver ion antibacterial functional dressing combined with NPWT in the treatment of patients with chronic infectious wounds is effective, and can further reduce their inflammatory reaction, dressing changes, and pain degree, and accelerate their wound healing, so it is worthy of clinical application and promotion.

Key words:

Chronic wounds, Infectioun, Silver ion antibacterial functional dressing, Negative pressure wound treatment technology, Clinical efficacy

摘要：

目的　研究分析慢性感染性创面患者应用银离子抗菌功能性敷料联合负压创面治疗技术（NPWT）治疗的临床效果。方法　选取2017年10月至2022年10月在南京中医药大学连云港附属医院治疗的慢性感染性创面患者114例为研究对象，根据随机抽签法将患者分为对照组与研究组，每组57例。对照组中，女27例，男30例，年龄（57.12±3.76）岁，病程（30.24±4.52）d，给予NPWT治疗；研究组中，女26例，男31例，年龄（56.85±3.91）岁，病程（30.01±4.29）d，给予NPWT与银离子抗菌功能性敷料联合治疗。观察两组患者临床疗效、炎性因子［超敏-C反应蛋白（hs-CRP）、降钙素原（PCT）、纤维蛋白原（FIB）］水平、换药次数、创面愈合时间、疼痛程度、创面闭合指数，采用χ²、t检验对两组观察数据进行统计分析。结果　研究组临床总有效率为98.25%（56/57），对照组为85.96%（49/57），差异有统计学意义（χ²=4.343，P<0.05）。治疗后，研究组hs-CRP、PCT、FIB分别为（8.41±0.85）mg/L、（0.33±0.10）μg/L、（3.94±0.61）g/L，均低于对照组［（9.25±0.89）mg/L、（0.40±0.11）μg/L、（4.42±0.66）g/L］，差异均有统计学意义（t=5.153、3.555、4.032，均P<0.05）。研究组换药次数（9.78±3.54）次，创面愈合时间（19.43±5.13）d，疼痛程度（3.89±1.34）分，对照组分别为（15.34±4.34）次、（25.67±5.51）d、（4.76±1.51）分，两组比较差异均有统计学意义（t=7.495、6.258、3.254，均P<0.05）。研究组治疗7 d、14 d、21 d、28 d后创面闭合指数分别为（39.54±4.46）分、（56.34±3.74）分、（80.24±5.85）分、（96.03±3.24）分，均高于对照组［（36.40±4.38）分、（54.25±3.35）分、（70.46±5.18）分、（87.65±4.32）分］，差异均有统计学意义（t=3.792、3.143、9.450、11.716，均P<0.05）。结论　慢性感染性创面患者应用银离子抗菌功能性敷料联合NPWT治疗的效果更确切，能够进一步减轻患者炎性反应、疼痛程度，减少换药次数，加快创面愈合，值得临床应用与推广。

关键词:

慢性创面, 感染, 银离子抗菌功能性敷料, 负压创面治疗技术, 临床疗效