納米銀燒燙傷貼與常規(guī)凡士林紗布治療糖尿病足的療效比較

陳文健　廖米榮

[摘要] 目的 比較納米銀燒燙傷貼與常規(guī)凡士林紗布治療糖尿病足（DF）的療效。 方法 選取2014年1月～2018年7月DF患者86例，隨機分為觀察組和對照組各43例。兩組均予以飲食控制、藥物控制血糖、抗感染、營養(yǎng)神經(jīng)及改善微循環(huán)等治療，并予以徹底清除局部壞死組織，充分引流，防止創(chuàng)面擴大，后采用不同敷料覆蓋創(chuàng)面。對照組采用常規(guī)凡士林紗布覆蓋創(chuàng)面，觀察組采用納米銀燒燙傷貼覆蓋創(chuàng)面。觀察兩組治療后傷口愈合效果，8周后比較其臨床療效。 結果 觀察組肉芽出現(xiàn)時間、創(chuàng)面愈合時間、換藥次數(shù)及住院時間均明顯優(yōu)于對照組（P<0.05）。治療8周后，觀察組臨床總有效率較對照組明顯更佳（χ2=4.07，P<0.05）。 結論 納米銀燒燙傷貼治療DF的療效確切，能促進肉芽組織生長，顯著縮短創(chuàng)面愈合時間，減少換藥次數(shù)和縮短住院時間。

[關鍵詞] 糖尿病足;納米銀燒燙傷貼;凡士林紗布;傷口愈合

[中圖分類號] R259? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2020）01-0113-03

Comparison of the efficacy between nano-silver burn scald stickers and conventional vaseline gauze in treating diabetic foot

CHEN Wenjian? ?LIAO Mirong

Department of Burn and Plastic Surgery， Taizhou Medical Center （Group） Enze Hospital in Zhejiang Province， Taizhou? ?318000， China

[Abstract] Objective To compare the efficacy of nano-silver burn scald stickers and conventional vaseline gauze in the treatment of diabetic foot （DF）. Methods 86 patients with DF from January 2014 to July 2018 were randomly divided into observation group （n=43） and control group （n=43）. Both groups were treated with diet control， drug control of blood sugar， anti-infection， nutritional nerves and microcirculation improvement. They were thoroughly debrided to remove local necrotic tissue， fully drain， and prevent the wounds from expanding. Then the wounds were covered with different dressings. The control group was covered with conventional vaseline gauze. The wound of the observation group was covered with nano silver burn scald stickers. The wound healing effect of the two groups after treatment was observed， and the clinical efficacy was compared after 8 weeks. Results The granulation time， wound healing time， dressing times and hospitalization time of the observation group were significantly better than those of the control group（P<0.05）. After 8 weeks of treatment， the total clinical effective rate of the observation group was significantly better than that of the control group （χ2=4.07， P<0.05）. Conclusion Nano-silver burn scald stickers in the treatment of DF has exact efficacy， which can promote the growth of granulation tissue， significantly shorten the wound healing time， reduce the number of dressing changes and shorten the hospital stay.

[Key words] Diabetic foot; Nano-silver burn and scald stickers; Vaseline gauze; Wound healing

糖尿病足（Diabetic foot，DF）是晚期糖尿病引起慢性足部感染，主要表現(xiàn)為足部皮膚破潰、感染化膿、劇烈疼痛等臨床癥狀，嚴重者可引起下肢壞疽，甚至截肢。因此，如何控制DF病情的進展，降低患者的截肢率是目前臨床需迫切解決的問題[1-2]。以往常規(guī)換藥使用的常規(guī)凡士林紗布易粘連創(chuàng)面，換藥時揭除敷料損傷新生的肉芽組織并引起局部疼痛，影響傷口愈合[3-4]。納米銀燒燙傷貼是一種新型的含銀離子廣譜抗菌敷料，能持續(xù)釋放低濃度銀離子殺滅細菌，形成局部抗菌環(huán)境，抑制微生物生長及促進傷口愈合，常用于慢性感染傷口治療中，但其用于DF的治療中臨床報道不多[5-6]。本研究比較納米銀燒燙傷貼與常規(guī)凡士林紗布治療DF的療效，現(xiàn)報道如下。……