CAJ | 학술논문

目的：比较复合季铵盐、0.1%醋酸氯己定、0.5%碘伏对烧伤创面清创时的临床疗效及安全性。方法选取2012年6～9月收治的120例需要清创的烧伤科门诊或住院患者，按随机数字表法分配至复合季铵组、醋酸氯己定组和碘伏组，每组各40例患者。清创前后取样行细菌培养并计算单位面积菌落数及各组清创剂对不同细菌的有效率。清创时行疼痛程度评分，随访观察不良反应。对数据行卡方检验、秩和检验、Fisher确切概率法检验和方差分析。结果本次试验烧伤创面细菌培养结果以金黄色葡萄球菌及铜绿假单胞菌为主。复合季铵盐组的清创有效率（93.75%）显著高于醋酸氯己定组（70.59%）和碘伏组（66.67%），差异有统计学意义（P＜0.05）；复合季铵盐组对金黄色葡萄球菌及铜绿假单胞菌的清创有效率高于其他两组，但差异无统计学意义（P＞0.05）。各组患者在清创时的疼痛评分无显著差异（P＞0.05）。120例患者试验期间均未见与清创剂使用相关的不良反应。结论在烧伤创面使用复合季铵盐消毒剂消毒能更有效地清除致病菌，相较于传统的消毒剂，其对创面表面的耐药菌可能有更好的清创效果。
목적：비교복합계안염、0.1%작산록기정、0.5%전복대소상창면청창시적림상료효급안전성。방법선취2012년6～9월수치적120례수요청창적소상과문진혹주원환자，안수궤수자표법분배지복합계안조、작산록기정조화전복조，매조각40례환자。청창전후취양행세균배양병계산단위면적균락수급각조청창제대불동세균적유효솔。청창시행동통정도평분，수방관찰불량반응。대수거행잡방검험、질화검험、Fisher학절개솔법검험화방차분석。결과본차시험소상창면세균배양결과이금황색포도구균급동록가단포균위주。복합계안염조적청창유효솔（93.75%）현저고우작산록기정조（70.59%）화전복조（66.67%），차이유통계학의의（P＜0.05）；복합계안염조대금황색포도구균급동록가단포균적청창유효솔고우기타량조，단차이무통계학의의（P＞0.05）。각조환자재청창시적동통평분무현저차이（P＞0.05）。120례환자시험기간균미견여청창제사용상관적불량반응。결론재소상창면사용복합계안염소독제소독능경유효지청제치병균，상교우전통적소독제，기대창면표면적내약균가능유경호적청창효과。
Objective To compare the clinical efficacy and safety between the quaternary ammonium salt compound, 0.1%chlorhexidine acetate and 0.5%iodophor on burn debridement. Methods 120 cases with burn wound who were in admission from June 2012 to September 2012 were randomly allocated accordingly to the quaternary ammonium salt compound group, 0.1% chlorhexidine acetate group and the iodophor group. There were 40 cases in each group. Bacteriological cultures were made before and after debridement. The numbers of colonies per unit area were calculated for each and the efficient of debridement was evaluated. The pain scores and the adverse reactions were also observed. The data was analyzed by Chi-square test, rank sum test, Fisher exact test and analysis of variance. Results The main bacteria cultured from tested wounds were staphylococcus aureus and pseudomonas aeruginosa. The effective rates of the quaternary ammonium salt compound group, 0.1%chlorhexidine acetate group and the iodophor group were:93.75%, 70.59%, 66.67%(P<0.05). The efficiency of the quaternary ammonium salt compound against staphylococcus aureus and pseudomonas aeruginosa was higher than the other two groups, but the difference was not statistically significant (P>0.05). The pain scores in each group showed no significant difference (P>0.05). 120 patients showed no adverse reactions during the trial. Conclusion Using the quaternary ammonium salt compound disinfectant can more effectively remove bacteria on burn wound surface, especially drug-resistance bacteria.