易倩　高丽　张丽

[摘要]目的：分析濕润烧伤膏联合银离子敷料治疗压疮的临床疗效及对炎性因子及愈合美观度的影响。方法：选取笔者医院2017年4月-2020年4月收治的162例感染性压疮患者作为研究对象。根据不同治疗方法分为A组（湿润烧伤膏治疗）、B组（银离子敷料治疗）及C组（湿润烧伤膏联合银离子敷料治疗）。比较三组临床疗效、炎性因子水平变化情况、患者对皮肤美观的满意度情况。结果：A组治疗后总有效率为74.14%;B组治疗后总有效率为73.81%;C组治疗后总有效率为93.55%，组间比较差异有统计学意义（P<0.05）。治疗后，三组IL-8、IL-6、hs-CRP、TNF-α水平均较治疗前降低，且C组均明显低于A、B组，差异有统计学意义（P<0.05）。C组扁平瘢痕率显著高于A、B组，瘢痕增生率显著低于A、B组，差异有统计学意义（P<0.05）。结论：采用湿润烧伤膏联合银离子敷料治疗压疮患者可提高其临床疗效，降低炎症因子水平，可使患者获得更佳愈合美观度，值得临床借鉴使用。

[关键词]压疮;湿润烧伤膏;银离子敷料;炎性因子;临床疗效

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）09-0054-04

Efficacy of Moisture Exposed Burn Ointment （MEBO）Combined with Silver Ion Dressing in the Treatment of Pressure Ulcer and its Effect on Related Inflammatory Factors

YI Qian1，GAO Li1，ZHANG Li2

（1.Department of Burns Plastic Surgery;2.Department of Hepatobiliary  and Pancreatic Surgery，Deyang City People's Hospital，Deyang 618000，Sichuan，China）

Abstract： Objective  To analyse the effect of MEBO combined with silver ion dressing on the clinical efficacy， inflammatory factors and healing aesthetics of patients with pressure sores. Methods  The clinical data of 162 patients with infectious pressure sores admitted to our hospital from April 2017 to April 2020 were retrospectively analyzed. According to different treatments， they were divided into the group A （MEBO treatment）， the group B（silver ion dressing treatment） and the group C （MEBO combined with silver ion dressing treatment）. The clinical efficacy， changes in inflammatory factor levels， and patients' satisfaction with skin aesthetics were compared between the three groups. Results  The total effective rate after treatment in the group A was 74.14%， the total effective rate after treatment in the group B was 73.81%， and the total effective rate after treatment in the group C was 93.55%， the differences between groups were statistically significant （P<0.05）. After treatment， the levels of IL-8， IL-6， hs-CRP and TNF-α in the three groups were lower than those before treatment， and the levels of the group C were significantly lower than those of the group A and B （P<0.05）. The rate of flat scars of the group C was significantly higher than that of the group A and B， and the rate of scar proliferation was significantly lower than that of the group A and B （P<0.05）. Conclusion  The use of MEBO combined with silver ion dressing in the treatment of patients with pressure ulcers can improve their clinical efficacy， reduce the level of inflammatory factors，can give patients a better artistic degree in healing， which is worthy of clinical reference and use.

Key words： pressure sores; MEBO; silver ion dressing; inflammatory factors; clinical efficacy

长期卧床、脊髓损伤、慢性神经系统疾病、各种消耗性疾病及老年患者由于身体局部组织长期受压，血液循环受阻，无法适当供给皮肤和皮下组织所需营养，导致局部组织失去正常功能而形成溃烂和组织坏死，形成压疮[1]。上述类型患者多合并营养不良、贫血，导致压疮发生后患者创面常出现感染，进而使创面炎症反应程度加重，临床处理上存在一定难度[2-3]。湿润烧伤膏是由我国烧伤学科带头人徐荣祥教授研究发明并监制的外用药品，具有活血化瘀、消肿止痛等作用;含银敷料是近年来用于慢性伤口治疗的一种新型抗菌敷料，是利用银特有的抗菌性将不同形式的银与敷料结合制成的不同种类的银敷料。敷料中的银通过抑制细菌、真菌、病毒等多种微生物的繁殖，加速伤口愈合。……