应用苯扎氯铵与碘伏清创换药治疗感染创面的临床观察Application of benzalkonium chloride and iodophor clinical observation of debridement and dressing in treatment of infected wound.pdfVIP

提 要 目的:通过56例肢体感染创面病例因感染流脓严重无法行皮瓣转移术或皮肤移植 术,而仅仅通过清创手术后，进行外科换药, 分别用苯扎氯铵和碘伏冲洗创面，让其自 行生长以达到创面愈合的临床病例研究，观察用苯扎氯铵和碘伏清创换药治疗皮肤大 面积缺损的疗效，并探讨影响创面修复的相关因素。方法：将所收治的病例患者随机 分为苯扎氯铵组和碘伏组，先于手术室彻底清创 （可视具体情况择期行第二次清创）， 每日行外科清创换药，以0.05 %苯扎氯铵溶液或碘伏冲洗创面，再覆盖一层无菌敷料， 稍加包扎，以保持创面湿润，利于新生组织生长。记录创面的容积和面积大小以及细 菌培养结果，观察创面愈合的质量。结果：二者对局部的感染均有较强的控制能力； 二者临床应用均比较安全；苯扎氯铵组创面肉芽生长速度和皮肤爬行速度均明显快于 碘伏组创面（p0.05 ）；有内固定物组创面修复慢于无内固定物组。结论：苯扎氯铵 对皮肤缺损创面有显著的促修复作用，有较强的杀菌控制局部感染作用，能加速创面 的愈合，加快皮肤爬行速度，且对皮肤无刺激性，临床效果优于碘伏，内固定物减缓 创面的修复速度。 关键词 苯扎氯铵；碘伏；皮肤缺损; 感染；创面修复； The Clinical observation of debridement and dressing to treat the infection Wounds by benzalkonium chloride and Iodophor Speciality: Orthopaedics of TCM Author:Liu Hengping Tutor:Prof.Wang Mingxi Abstract Objective ：Through the clinical study of the 56 cases of patients with big body skin areas damage who got healed by merely applying the benzalkonium chloride and the iodine separately to flush the injured areas after having the skin cleaned in the sugical department and let it grow voluntarily to achieve the clinical curement ,instead of operating skin transplant techniques. to observe the curative effect of the benzalkonium chloride on treating large body skin damage and to explore the impact of factors related to wound healing. Method: The experimental group got thorough cleaning in the operating room as the first step (the second time cleaning initiation depends on the specific situation and specific date ),operate daily surgical cleaning and medicine changing, and flush the injured area by 0.05% benzalkonium chloride, then cover it with sterilized dressing, wrap it up slightly, maintain the injured area moist, which favors the growth of the newborn tissue.The control group ap