CAJ | 학술논문

目的：观察两种银敷料用于下肢静脉溃疡治疗的效果，以指导银敷料在伤口治疗中的合理使用。方法对入选的75例下肢静脉溃疡患者随机分为观察组和对照组，观察组使用进口的银离子藻酸盐敷料，对照组使用国产纳米银敷料处理局部溃疡，两组患肢均给予弹力绷带压力治疗，并接受28 d的治疗方案，研究结束时伤口未愈者选择湿性愈合技术处理至愈合或外科手术治愈。观察治疗7 d、14 d、21 d时溃疡伤口细菌转阴率，研究结束时溃疡面积愈合率和愈合效果，并于每次处理伤口时观察评价伤口床表现(渗液清除时间、肉芽分级和周围皮肤状况)。结果两组伤口面积愈合率平均为(84.66±10.56)%和(67.33±9.44)%，其中，观察组完全愈合8例、基本愈合17例、有效12例，对照组完全愈合4例、基本愈合11例、有效22例，两组差异均有统计学意义(P<0.05)；两组伤口细菌转阴率随着时间的延长均增加，28 d时细菌转阴率均达100%，差异无统计学意义(P>0.05)；随着治疗时间的增加，两组伤口表现也显著改善，观察组的效果要明显优于对照组，差异有统计学意义(P<0.05)。结论两种银敷料均可清除溃疡伤口感染，改善伤口床的表现，促进溃疡愈合，银敷料治疗下肢静脉性溃疡伤口有效，但银离子藻酸盐敷料的有效性更优越。
목적：관찰량충은부료용우하지정맥궤양치료적효과，이지도은부료재상구치료중적합리사용。방법대입선적75례하지정맥궤양환자수궤분위관찰조화대조조，관찰조사용진구적은리자조산염부료，대조조사용국산납미은부료처리국부궤양，량조환지균급여탄력붕대압력치료，병접수28 d적치료방안，연구결속시상구미유자선택습성유합기술처리지유합혹외과수술치유。관찰치료7 d、14 d、21 d시궤양상구세균전음솔，연구결속시궤양면적유합솔화유합효과，병우매차처리상구시관찰평개상구상표현(삼액청제시간、육아분급화주위피부상황)。결과량조상구면적유합솔평균위(84.66±10.56)%화(67.33±9.44)%，기중，관찰조완전유합8례、기본유합17례、유효12례，대조조완전유합4례、기본유합11례、유효22례，량조차이균유통계학의의(P<0.05)；량조상구세균전음솔수착시간적연장균증가，28 d시세균전음솔균체100%，차이무통계학의의(P>0.05)；수착치료시간적증가，량조상구표현야현저개선，관찰조적효과요명현우우대조조，차이유통계학의의(P<0.05)。결론량충은부료균가청제궤양상구감염，개선상구상적표현，촉진궤양유합，은부료치료하지정맥성궤양상구유효，단은리자조산염부료적유효성경우월。
Objective To observe the effects of two silver dressing in the treatment of venous leg ulcer, and to guide proper use of silver dressings on wound treatments. Methods Seventy-five patients with venous leg ulcers were randomly divided into two groups:the observation group and the control group. The observation group was treat-ed with imported silver ion alginate dressing, and the control group was treated with domestic nanometer silver dress-ing. Elastic bandages were applied to affect extremities of two groups. The treatment lasted for 28 days. The bacterial clearance rate of ulcer wound was compared 7 d, 14 d, 21 d after treatment. The performance of the wound bed (fluid clearance time, granulation grading and the surrounding skin condition) was observed whenever the wound was cared. The healing rate and effect of ulcer area was evaluated at the end of the research. Results The average healing rate of the two groups was (84.66±10.56)%and (67.33±9.44)%. In the observation group, 8 cases were completely healed,17 cases were almost healed, 12 cases were effective. In the control group, 4 cases were completely healed, 11 cases were almost healed, 22 cases were effective. The two groups showed statistically significant difference (P<0.05). The bacte-rial clearance rate of ulcer wound in the two groups increased with time, which both reached 100%28 d after treat-ment, with no statistically significant difference. There was significant improvement in the performance of wound bed in the two groups. The effect of the observation group was more significant than the control group, and the difference was statistically significant (P<0.05).Conclusion Both the two silver dressings can clear wound infection, improve wound performance, and promote wound healing. Silver dressings are effective for treating venous leg ulcer wound, but the effectiveness of the silver ion alginate dressing is superior.