中华损伤与修复杂志(电子版) ›› 2024, Vol. 19 ›› Issue (06) : 511 -516. doi: 10.3877/cma.j.issn.1673-9450.2024.06.011 × 扫一扫
论著
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通信作者:
Ling Peng1, Hong Wu1, Shiyong Wan1, Lan Chen1, Ziqing Ye1, Jing Zhou1,†()
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彭玲, 吴红, 宛仕勇, 陈斓, 叶子青, 周静. 胶原酶软膏联合水胶体敷料应用于深Ⅱ度烧伤创面治疗的效果观察[J]. 中华损伤与修复杂志(电子版), 2024, 19(06): 511-516.
Ling Peng, Hong Wu, Shiyong Wan, Lan Chen, Ziqing Ye, Jing Zhou. Observation on the efficacy of collagenase ointment combined with hydrogel dressing in the treatment of deep partial-thickness burn wounds[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(06): 511-516.
目的
观察胶原酶软膏联合水胶体敷料治疗深Ⅱ度烧伤创面的临床效果。
方法
选择武汉大学同仁医院暨武汉市第三医院烧伤科2022 年1 月至2023 年6 月收治的符合纳入与排除标准的66 例深Ⅱ度烧伤患者为研究对象。 采用随机数字表法将患者分为观察组和对照组，每组33 例。观察组患者采用胶原酶软膏联合水胶体敷料治疗，对照组患者采用碘伏凡士林纱布常规换药治疗。记录2 组患者创面愈合时间、创面感染率及创面坏死组织清除率。 每次换药完毕时，采用视觉模拟评分法（VAS）评估患者疼痛程度。 采用改良温哥华瘢痕量表（mVSS）评估治疗后第3 个月和第12 个月创面瘢痕情况。
结果
观察组和对照组创面愈合时间分别为（12.09±1.75）d 和（12.97±1.88）d，差异无统计学意义（t=1.935， P=0.057）。 观察组创面感染率为9.09%（3/33），对照组为6.06%（2/33），差异无统计学意义（P=1.000）。 在治疗后第5～7 天，观察组创面坏死组织清除率为（73.91±17.52）%，高于对照组的（58.91±13.30）%，差异有统计学意义（t=3.916， P＜0.001）。 在治疗后第5～7 天，观察组患者换药时VAS 评分为（1.94±1.17）分，低于对照组的（2.68±1.03）分，差异有统计学意义（t=3.475， P=0.001）。 在治疗后第3 个月，观察组mVSS 评分厚度评分及总分［（1.54±0.60）分、（8.73±1.71）分］均低于对照组［（1.93±0.63）分、（9.85±1.65）分］，差异均有统计学意义（t=2.198， P=0.032；t=2.666， P=0.010）。 在治疗后第12 个月，观察组mVSS 总分［（3.67±1.39）分］低于对照组［（4.38±1.39）分］，差异有统计学意义（t=2.181， P=0.047）；mVSS 各分项评分差异无统计学意义（P＞0.05）。
结论
胶原酶软膏联合水胶体敷料治疗深Ⅱ度烧伤创面具有良好的临床效果，能够减轻创面疼痛，减少坏死组织，抑制瘢痕增生。
Objective
To evaluate the clinical efficacy of collagenase ointment combined with hydrogel dressing in the treatment of deep partial-thickness burn wounds.
Methods
A total of 66 patients with deep partial-thickness burn wounds were admitted to Department of Burns， Tongren Hospital of Wuhan University & Wuhan Third Hospital from January 2022 to June 2023 who met the inclusion and exclusion criteria were enrolled as the study subjects.The patients were divided into observation group and control group according to random number table，with 33 patients in each group.The patients in the observation group received collagenase ointment combined with hydrogel dressing treatment， while the patients in the control group received iodine tincture vaseline gauze dressing treatment.The wound healing time， wound infection rate， necrotic tissue clearance rate， pain score， and modified Vancouver scar scale （mVSS） scores at 3 months and 12 months after treatment were recorded for both groups.
Results
The wound healing time in the observation group and the control group was （12.09±1.75）d and （12.97±1.88）d respectively， with no statistically significant difference （t=1.935， P=0.057）.No significant difference was found in wound infection rate between the two groups ［9.09%（3/33） vs 6.06%（2/33），P=1.000］.From day 5 to day 7 post-treatment，the necrotic tissue debridement rate in the observation group was （73.91±17.52）%， statistically higher than（58.91±13.30）% of the control group （t=3.916， P＜0.001）.From day 5 to day 7 post-treatment， the mVAS score during changing dressings was 1.94±1.17 in the observation group and 2.68±1.03 in the control group， with statistically significant difference （t= 3.475， P= 0.001）.At 3 months post-treatment， the thickness score on the mVSS scale in the observation group was 1.54±0.60， lower than 1.93±0.63 in the control group （t=2.198， P=0.032）， and the total mVSS score in the observation group was 8.73±1.71，lower than 9.85±1.65 in the control group， which was statistically different between the two groups（t=2.666，P=0.010）.At 12 months post-treatment， the total mVSS score in the observation group was 3.67±1.39， lower than 4.38±1.39 in the control group， with statistically significant difference （t=2.181， P=0.047）.There was no significant difference in sub-item scores of mVSS between the two groups（P＞0.05）.
Conclusion
The application of collagenase ointment combined with hydrogel dressing has good clinical efficacy in the treatment of deep partial-thickness burn wounds.It can effectively alleviate wound pain， reduce necrotic tissue， and inhibit scar hypertrophy.