| 范新明,刘 莹,邹明平,熊赖焱,罗细成.心内科住院患者压疮感染病原菌分析及纳米银抗菌凝胶的干预效果[J].,2019,19(9):1675-1678 |
| 心内科住院患者压疮感染病原菌分析及纳米银抗菌凝胶的干预效果 |
| Pressure Ulcer Infection in Patients Hospitalized in Cardiovascular Department: Analysis of Pathogenic Bacteria and Intervention Effect of Nano Silver Antibacterial Gel |
| 投稿时间：2018-08-23 修订日期：2018-09-18 |
| DOI：10.13241/j.cnki.pmb.2019.09.015 |
| 中文关键词: 心内科 压疮 感染 病原菌 纳米银抗菌凝胶 疗效 |
| 英文关键词: Cardiovascular department Pressure ulcer Infection Pathogenic bacteria Nano silver antibacterial gel Curative effect |
| 基金项目:广东省科技计划项目（2013B0212013） |
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| 中文摘要: |
| 摘要 目的：探讨心内科住院患者压疮感染病原菌分布和耐药情况，并研究纳米银抗菌凝胶的干预效果，为临床治疗提供参考。方法：选取2017年3月-2018年3月我院诊治的80例心血管内科住院并发Ⅱ期压疮感染患者，采集患者压疮感染部位样本进行病原菌培养及药敏试验。记录病原菌分布情况，分析主要革兰阴性菌和主要革兰阳性菌的耐药率。采用随机数字表法将患者分为实验组（n=40）和对照组（n=40），对照组采用安普贴治疗，实验组采用纳米银抗菌凝胶联合安普贴治疗，比较两组患者的治疗效果。结果：80例心内科住院并发II期压疮感染患者中，共分离鉴定出病原菌71株，其中革兰阴性菌54株，占76.06%，革兰阳性菌13株，占18.31%，真菌4株，占5.64%。大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌均对氨苄西林、亚胺培南和头孢曲松的耐药率较高，分别为100.00%、90.91%、95.45%；93.33%、80.00%、100.00%；100.00%、90.00%、90.00%；而对环丙沙星和庆大霉素的耐药率较低，分别为27.27%、9.09%；0.00%、0.00%；40.00%、20.00%。金黄色葡萄球菌和肠球菌属对氨苄西林、青霉素G和克林霉素的耐药率较高，分别为100.00%、87.50%、62.50%；100.00%、66.67%、66.67%；对万古霉素和替考拉宁的耐药率均为0.00%。实验组治疗总有效率为95.00%，高于对照组的77.50%，差异有统计学意义（P<0.05）。结论：心内科住院并发Ⅱ期压疮感染患者病原菌分布比较广泛，主要以革兰阴性菌为主，患者辅以纳米银抗菌凝胶治疗效果较好。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the distribution of pathogenic bacteria and drug resistance of patients with pressure ulcer infection hospitalized in cardiovascular department, and study the intervention effect of nano silver antibacterial gel, in order to provide reference for clinical treatment. Methods: A total of 80 patients with stage II pressure ulcer infection, who were hospitalized in cardio- vascular department of Affiliated Donghua Hospital of Sun Yat-sen University from March 2017 to March 2018, were selected, and the samples from the pressure ulcer infection site were collected for the pathogenic bacteria culture and drug sensitive test. The distribution of pathogenic bacteria was recorded, and the resistance rates of main gram negative bacteria and main gram positive bacteria were ana- lyzed. All the patients were randomly divided into experimental group(n=40) and control group(n=40). The control group was treated with Algoplaque, while the experimental group was treated with nano silver antibacterial gel combined with Algoplaque, then the clinical effect was compared between the two groups. Results: 71 strains of pathogenic bacteria were identified from 80 patients, including 54 strains of gram negative bacteria, accounting for 76.06%; 13 strains of gram positive bacteria, accounting for 18.31%, and 4 strains of fun- gus, accounting for 5.64%. Escherichia coli, pneumonia klebsiella and pseudomonas aeruginosa bacteria were highly resistant to ampicillin, imipenem and ceftriaxone, the resistance rates were 100.00%, 90.91%, 95.45%; 93.33%, 80.00%, 100.00%; 100.00%, 90.00%, 90.00% respectively, but they had low resistant to ciprofloxacin and gentamicin, the resistance rates were 27.27%, 9.09%; 0.00%, 0.00%; 40.00%, 20.00% respectively. And staphylococcus aureus and enterococcus genera were highly resistant to ampicillin, penicillin G and clindamycin, the resistance rates were 100.00%, 87.50%, 62.50%; 100.00%, 66.67%, 66.67% respectively, but they had low resistance to vancomycin and teicoplanin, the resistance rates were all 0.00%. The total effective rate of experimental group was 95.00%, which was significantly higher than 77.50% of control group(P<0.05). Conclusion: The distribution of pathogenic bacteria in the patients with stage II pressure ulcer infection in cardiology department is relatively wide, mainly Gram-negative bacteria, and good therapeutic effect will be obtained by using nano-silver antibacterial gel in the treatment of the patients. |
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