[FE复合酶对烧伤后期肉芽创面感染影响的临床观察]
[Clinical observation of the effects of FE combined enzymes on the infection of the granulation burn wound during late post burns stage].
作者信息
Zheng Ji, Liu Xu-sheng, Huang Yue-sheng, Liu Chun-yu
机构信息
Institute of Burn Research, Southwest Hospital, The Third Military Medical University, State Key Laboratory of Trauma, Burns and Combined Injury, Chongqing 400038, PR China.
出版信息
Zhonghua Shao Shang Za Zhi. 2006 Feb;22(1):26-8.
OBJECTIVE
To observe the effects of combined FE enzymes on the infection of the granulation burn wound during late postburn stage in controlling burn wound infection caused by common antibiotic resistant bacteria.
METHODS
Thirty patients in our burn ward were enrolled and were randomly divided into A [treated with combined FE enzymes (50 ml dissolved in 0-150 ml normal saline to reach the final concentration of 1-3 U/ml)] and B (treated with gentamicin) groups, with 15 patients in each group. Several layers of gauze, either soaked with combined FE enzyme in A or gentamicin in B group, were used to cover the burn wounds once to twice a day. Bacterial culture from the burn wound exudation before and after drug administration was done before the application of the agents. The bacteria in the burn wounds and their susceptibility to antibiotics were identified. The healing time of the burn wounds was recorded. Furthermore, the healing rate of the burn wound was recorded on the 3rd, 5th, 8th, 10th and 12th post skin grafting days (PSGD).
RESULTS
The dominating bacteria in the burn wounds in both groups were Pseudomonas aeruginosa, Escherichia coli, Enterobacter cloacae and MRSA. The susceptibility rate of bacteria ( MRSA, Staphylococcus epidermidis, Staphylococcus saprophyte, Pseudomonas aeruginosa, Escherichia coli and Enterobacter cloacae) to combined FE enzyme was 93.8%, 100.0%, 100.0%, 100.0%, 100.0% and 95.0% respectively, which were much higher than those in B group (17.6%, 31.3%, 28.6%, 44.0%, 33.3%, 28.0% respectively, P < 0.1. The wound healing time after skin grafting in A group (10.6 +/- 1.5 days) was significantly shorter than that in B group (15.3 +/- 1.7 days, P < 0.01). The wound healing rate on 10 PSGD in A group was (85.4 +/- 2.4)%, and which was only (51.3 +/- 1.5% in B group (P < 0.01)
CONCLUSION
Combined FE enzyme can effectively control burn wound infection, so that the interval between skin grafting and wound healing can be shortened and success rate of skin grafting be improved.
目的
观察复合FE酶对烧伤后期肉芽创面感染的影响，以控制常见耐抗生素细菌引起的烧伤创面感染。
方法
选取我院烧伤病房30例患者，随机分为A组[用复合FE酶治疗（50 ml溶解于0 - 150 ml生理盐水中，最终浓度达1 - 3 U/ml）]和B组（用庆大霉素治疗），每组15例。每天用几层浸有A组复合FE酶或B组庆大霉素的纱布覆盖烧伤创面1至2次。在用药前对烧伤创面渗出物进行给药前后的细菌培养。鉴定烧伤创面中的细菌及其对抗生素的敏感性。记录烧伤创面的愈合时间。此外，在植皮后第3、5、8、10和12天记录烧伤创面的愈合率。
结果
两组烧伤创面的主要细菌均为铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌和耐甲氧西林金黄色葡萄球菌。细菌（耐甲氧西林金黄色葡萄球菌、表皮葡萄球菌、腐生葡萄球菌、铜绿假单胞菌、大肠埃希菌和阴沟肠杆菌）对复合FE酶的敏感率分别为93.8%、100.0%、100.0%、100.0%、100.0%和95.0%，远高于B组（分别为 17.6%、31.3%、28.6%、44.0%、33.3%、28.0%，P < 0.1）。A组植皮后的创面愈合时间（10.6±1.5天）明显短于B组（15.3±1.7天，P < 0.01）。A组植皮后10天的创面愈合率为（85.4±2.4）%，而B组仅为（51.3±1.5）%（P < 0.01）。
结论
复合FE酶能有效控制烧伤创面感染，从而缩短植皮与创面愈合的间隔时间，提高植皮成功率。
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