中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
36期
4311-4314
,共4页
汪洋%张小红%冉辉%谭加%陶宏军
汪洋%張小紅%冉輝%譚加%陶宏軍
왕양%장소홍%염휘%담가%도굉군
莫匹罗星%成纤维细胞生长因子%皮肤移植%感染
莫匹囉星%成纖維細胞生長因子%皮膚移植%感染
막필라성%성섬유세포생장인자%피부이식%감염
Mupirocin%Fibroblast growth factors%Skin transplantation%Infection
目的：探讨莫匹罗星、重组牛碱性成纤维细胞生长因子（ rb-bFGF）联合活性银离子治疗感染性创面游离植皮的疗效，为以后的治疗提供依据。方法选取2010年6月—2013年6月重庆三峡中心医院收治的行断层皮片封闭感染性创面手术的患者168例，采用随机数字表法分为观察组84例和对照组84例。观察组术中将莫匹罗星和rb-bFGF制成的混合液涂抹于受区，皮片移植后外用浸湿活性银离子的无菌绷带予以固定；对照组术中用油纱覆盖游离皮片。观察术后第4、8、12天创面情况，评估皮片存活率、创面愈合率、创面愈合时间及细菌清除率。皮片存活率、创面愈合率及细菌清除率比较采用χ2检验，创面愈合时间比较采用t检验。结果术后第4天观察组皮片存活率为（97.9±1.2）%，高于对照组的（85.8±5.7）%（t=20.62，P=0.002）。术后第8天观察组创面愈合率为7.1%（6/84），对照组为1.2%（1/84），差异无统计学意义（χ2=3.71，P =0.054）；术后第12天观察组创面愈合率为98.8%（83/84），高于对照组的72.6%（61/84）（χ2=23.39，P <0.001）。观察组创面平均愈合时间为（11.4±1.4）d，短于对照组的（13.3±3.0）d（t =-5.92，P =0.007）。术后第4天观察组细菌清除率为72.6%（61/84），高于对照组的46.4%（39/84）（χ2=11.89，P=0.001）；术后第8天观察组细菌清除率为90.5%（76/84），高于对照组的77.4%（65/84）（χ2=5.31，P=0.020）；术后第12天观察组细菌清除率为100.0%（84/84），高于对照组的94.0%（79/84）（χ2=5.12，P=0.023）。结论莫匹罗星、rb-bFGF联合活性银离子能提高感染性创面游离植皮的成活率、加速创面愈合、增强局部抗感染能力。
目的：探討莫匹囉星、重組牛堿性成纖維細胞生長因子（ rb-bFGF）聯閤活性銀離子治療感染性創麵遊離植皮的療效，為以後的治療提供依據。方法選取2010年6月—2013年6月重慶三峽中心醫院收治的行斷層皮片封閉感染性創麵手術的患者168例，採用隨機數字錶法分為觀察組84例和對照組84例。觀察組術中將莫匹囉星和rb-bFGF製成的混閤液塗抹于受區，皮片移植後外用浸濕活性銀離子的無菌繃帶予以固定；對照組術中用油紗覆蓋遊離皮片。觀察術後第4、8、12天創麵情況，評估皮片存活率、創麵愈閤率、創麵愈閤時間及細菌清除率。皮片存活率、創麵愈閤率及細菌清除率比較採用χ2檢驗，創麵愈閤時間比較採用t檢驗。結果術後第4天觀察組皮片存活率為（97.9±1.2）%，高于對照組的（85.8±5.7）%（t=20.62，P=0.002）。術後第8天觀察組創麵愈閤率為7.1%（6/84），對照組為1.2%（1/84），差異無統計學意義（χ2=3.71，P =0.054）；術後第12天觀察組創麵愈閤率為98.8%（83/84），高于對照組的72.6%（61/84）（χ2=23.39，P <0.001）。觀察組創麵平均愈閤時間為（11.4±1.4）d，短于對照組的（13.3±3.0）d（t =-5.92，P =0.007）。術後第4天觀察組細菌清除率為72.6%（61/84），高于對照組的46.4%（39/84）（χ2=11.89，P=0.001）；術後第8天觀察組細菌清除率為90.5%（76/84），高于對照組的77.4%（65/84）（χ2=5.31，P=0.020）；術後第12天觀察組細菌清除率為100.0%（84/84），高于對照組的94.0%（79/84）（χ2=5.12，P=0.023）。結論莫匹囉星、rb-bFGF聯閤活性銀離子能提高感染性創麵遊離植皮的成活率、加速創麵愈閤、增彊跼部抗感染能力。
목적：탐토막필라성、중조우감성성섬유세포생장인자（ rb-bFGF）연합활성은리자치료감염성창면유리식피적료효，위이후적치료제공의거。방법선취2010년6월—2013년6월중경삼협중심의원수치적행단층피편봉폐감염성창면수술적환자168례，채용수궤수자표법분위관찰조84례화대조조84례。관찰조술중장막필라성화rb-bFGF제성적혼합액도말우수구，피편이식후외용침습활성은리자적무균붕대여이고정；대조조술중용유사복개유리피편。관찰술후제4、8、12천창면정황，평고피편존활솔、창면유합솔、창면유합시간급세균청제솔。피편존활솔、창면유합솔급세균청제솔비교채용χ2검험，창면유합시간비교채용t검험。결과술후제4천관찰조피편존활솔위（97.9±1.2）%，고우대조조적（85.8±5.7）%（t=20.62，P=0.002）。술후제8천관찰조창면유합솔위7.1%（6/84），대조조위1.2%（1/84），차이무통계학의의（χ2=3.71，P =0.054）；술후제12천관찰조창면유합솔위98.8%（83/84），고우대조조적72.6%（61/84）（χ2=23.39，P <0.001）。관찰조창면평균유합시간위（11.4±1.4）d，단우대조조적（13.3±3.0）d（t =-5.92，P =0.007）。술후제4천관찰조세균청제솔위72.6%（61/84），고우대조조적46.4%（39/84）（χ2=11.89，P=0.001）；술후제8천관찰조세균청제솔위90.5%（76/84），고우대조조적77.4%（65/84）（χ2=5.31，P=0.020）；술후제12천관찰조세균청제솔위100.0%（84/84），고우대조조적94.0%（79/84）（χ2=5.12，P=0.023）。결론막필라성、rb-bFGF연합활성은리자능제고감염성창면유리식피적성활솔、가속창면유합、증강국부항감염능력。
Objective To study the efficacy of mupirocin ointment,recombinant bovine basic fibroblast growth factor ( rb-bFGF)combined with active silver ions solution on free skin graft in the treatment of infectious wound in order to provide reference for subsequent treatment. Methods 168 patients underwent closed infectious wound surgery for split-thickness skin in the Chongqing Three Gorges Central Hospital from June 2010 to June 2013 were selected and randomly divided into observation group(84 cases)and control group(84 cases). The wound of the observation group was swabbed with the mixture of mupirocin ointment and rb-bFGF,and the skin graft field was fixed with sterile bandages soaked in active silver ions solution. The control group was covered with vaseline gauze outside the free skin. The dressing change 4 d,8 d and 12 d after surgery was observed, and the skin graft survival rate,wound healing rate,wound healing time and bacterial clearance rate were evaluated. The skin graft survival rate,wound healing rate and bacterial clearance rate were assessed with χ2 test,and the wound healing time was assessed with t test. Results The survival rate of skin graft in the observation group 4 days after surgery was(97. 9 ± 1. 2)%, significantly higher than that of the control group(85. 8 ±5. 7)%(t=20. 62,P=0. 002). The wound healing rate in the ob-servation group 8 days after surgery was 7. 1%(6/84),the control group was 1. 2%(1/84),there was no significant differ-ence betwee the two groups(χ2 =3. 71,P=0. 054). The wound healing rate in observation group 12 days after surgery was 98. 8%(83/84),significantly higher than that of the control group 72. 6%(61/84)(χ2 =23. 39,P<0. 001). The average wound healing time in the observation group was(11. 4 ± 1. 4) d,significantly shorter than that of the control group(13. 3 ±3. 0)d(t= -5. 92,P =0. 007). The bacterial clearance rate in the observation group 4 days after surgery was 72. 6%(61/84),significantly higher than that of the control group 46. 4%(39/84)(χ2 =11. 89,P=0. 001). The bacterial clear-ance rate in the observation group 8 days after surgery was 90. 5%(76/84),significantly higher than that of the control group 77. 4%(65/84)(χ2 =5. 31,P =0. 020). The bacterial clearance rate in the observation group 12 days after surgery was 100. 0%(84/84),also significantly higher than that of the control group 94. 0%(79/84)(χ2 =5. 12,P=0. 023). Con-clusion Mupirocin ointment,rb-bFGF combined with high valence silver ions can improve the survival rate of wound infection free skin graft,accelerate wound healing,and enhance local resistance to infection.
