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目的:研究重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)、纳米银外用,对深Ⅱ°烫伤创面愈合过程病原菌分布及其耐药性分析。方法:用Wistar大鼠建立深Ⅱ°烫伤模型,分为A、B、C 3组,A组(30例):凡士林纱布覆盖,B组(30例):纳米银覆盖,C组(30例):rhGM-CSF涂抹创面,伤后第1,4,7,10,14,21天,创面分泌物细菌培养并计数,细菌分离鉴定,测定细菌耐药谱。结果:A组、B组、C组分别于伤后第4,10天出现细菌生长,第10,14,21天各组间差异有统计学意义(P<0.05)。革兰阳性菌以金黄色葡萄球菌居首位;革兰阴性菌以铜绿假单胞菌居首位。药敏试验结果显示,革兰阳性菌主要对青霉素G、环丙沙星、利福平、苯唑西林、氧氟沙星、庆大霉素、四环素等耐药,革兰阴性菌主要对哌拉西林、奈替米星、头孢吡肟、哌拉西林他唑巴坦、庆大霉素等耐药,病原菌对抗菌药物敏感性均为C组>B组>A组。结论:rhGM-CSF、纳米银外用,均减少深Ⅱ°烫伤创面细菌生长;提高病原菌对抗菌药物的敏感性,并且rhGM-CSF优于纳米银。
OBJECTIVE: To study the distribution and drug resistance of pathogenic bacteria in rhGM-CSF and nano-silver for deep second degree scald wound healing. Methods: A deep Ⅱ degree scald model was established in Wistar rats and divided into A, B and C groups. Group A (30 cases) covered with Vaseline gauze, group B (30 cases) covered with silver nanoparticles, Group C ): The wounds were smeared with rhGM-CSF. The wound secretions were cultured and counted on the 1st, 4th, 7th, 10th, 14th and 21st days after injury. The bacteria were isolated and identified and the bacterial resistance spectrum was determined. Results: Bacterial growth occurred on the 4th and 10th days in group A, group B and group C, respectively. There was a significant difference between the groups on the 10th, 14th and 21st days (P <0.05). Gram-positive bacteria Staphylococcus aureus ranks first; Gram-negative bacteria Pseudomonas aeruginosa ranks first. Drug sensitivity test results show that Gram-positive bacteria mainly penicillin G, ciprofloxacin, rifampicin, oxacillin, ofloxacin, gentamicin, tetracycline and other drug-resistant, Gram-negative bacteria mainly on the piperazine Lacillin, netilmicin, cefepime, piperacillin tazobactam, gentamicin and other drug-resistant, the sensitivity of pathogens to antibacterials were C group> B group> A group. Conclusion: rhGM-CSF and nano-silver for external use all reduce bacterial growth in deep Ⅱ ° scald wounds, increase the sensitivity of pathogens to antibiotics, and rhGM-CSF is superior to nano-silver.