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目的观察复合纳米银修复烧伤创面的效果。方法应用兔高压电损伤模型将新西兰兔45只击伤后分为3组。组1,局部应用复合纳米银凝胶治疗7 d;组2,单用纳米银凝胶治疗;组3,单用纳米级甲壳素溶液。伤后3、7、14、21和28 d分别解剖观察,并取标本做光镜学和电镜学观察;同时进行肌动蛋白和肌钙蛋白相对定量分析。临床应用65例:实行同体对照,一侧肢体(试验组)应用含有纳米银凝胶的纱布覆盖烧伤创面,另一侧(对照组)应用磺胺嘧啶银纱布。观察创面细菌培养结果和创面愈合时间。结果实验第3、7和14天,组1和组2肌动蛋白相对定量无显著差异,但在21 d和28 d,组1和组2肌动蛋白相对定量差异有统计学意义(P<0.05),而组1和组2肌钙蛋白相对定量无显著差异。临床观察结果:在65例患者130例次细菌培养结果中,试验组创面培养均为阴性,对照组有15例次阳性;试验组创面愈合时间为(17±5.8)d,对照组为(22±6.3)d,两组差异具有统计学意义(P<0.05)。65例患者均未见不良反应。结论复合纳米银凝胶具有防止感染,促进烧伤创面修复作用。
Objective To observe the effect of composite nano silver in repairing burn wounds. Methods 45 rabbits were divided into 3 groups by high voltage injury model. Group 1, local application of composite nano-silver gel treatment 7 d; group 2, single nano-silver gel treatment; group 3, single nano-scale chitin solution. At 3, 7, 14, 21 and 28 days after injury, the rats were dissected and observed under light microscopy and electron microscopy respectively. Relative quantification of actin and troponin was also performed. Clinical application of 65 cases: the implementation of the same body control, one side of the limb (test group) covered with gauze containing nano-silver gel burn wounds, the other side (control group) with silver sulfadiazine gauze. The wound bacterial culture results and wound healing time were observed. Results On the 3rd, 7th and 14th days, there was no significant difference in the relative quantification of actin between groups 1 and 2, but the relative quantification of actin between groups 1 and 2 was statistically significant at 21 d and 28 d (P < 0.05), while there was no significant difference between group 1 and group 2 in the relative quantification of troponin. The results of clinical observation: In the results of bacterial culture of 130 cases in 65 patients, the wounds of the experimental group were all negative, and 15 cases were positive in the control group. The wound healing time of the experimental group was (17 ± 5.8) days and that of the control group was (22 ± 6.3) d, the difference between the two groups was statistically significant (P <0.05). No adverse reactions were seen in 65 patients. Conclusion The composite nano-silver gel has the function of preventing infection and promoting the repair of burn wounds.