Clinical Observation Of Sulfadiazine Silver Combined With Yunnan Baiyao In The Treatment Of Stage 3 Pressure Ulcer

OBJECTIVE:To observe the efficacy of sulfadiazine silver cream combined with Yunnan Baiyao and sulfadiazine silver cream combined with MEBO in the treatment of stage 3 pressure ulcers,and to explore the method of external treatment of stage 3 pressure ulcers,so as to provide basis for clinical application.METHODS: From March 2017 to December 2018,60 patients with pressure sores who met the inclusion criteria in cardiovascular medicine,burn department,central ICU,emergency ICU,encephalopathy department,geriatrics department and orthopaedics ward were randomly divided into sulfadiazine silver combined with Yunnan white powder group(observation group),sulfadiazine silver cream combined with moist burn ointment group(control group),30 cases in each group.(2)The observation group was given sulfadiazine silver cream combined with Yunnan Baiyao powder for intervention,and the silver sulfadiazine was fully mixed with Yunnan Baiyao.According to the size of the wound,the outer layer of the silver sulfadiazine cream was evenly coated with1-2 mm mixture of drugs and covered with Vaseline gauze.The control group was given sulfadiazine silver cream combined with MEBO for treatment,and the silver sulfadiazine cream was fully mixed with 5 grams of MEBO.According to the size of the wound,the outer layer of the wound was evenly coated with 1-2 mm mixture of drugs and covered with sterile gauze.Both groups should keep in full contact with the wound and change the dressing once a day.The changes of wound area,PUSH score,healing rate of pressure ulcer and treatment efficiency were measured before treatment,1 week,2 weeks and 4 weeks after treatment.(3)Data were recorded and analyzed by SPSS19.0.The measurement data are described by percentage(%)and the counting data are described by percentage(%).Statistical analysis includes normality test,homogeneity test of variance,test,rank-based nonparametric test,sphericity test and variance analysis of repeated measurement data.RESULTS:1.Comparison of general data of patients:The two groups had comparability in age,sex,pressure ulcer area,PUSH score,Braden score and APACHE score(P>0.05)The indexes of liver and kidney function and fasting blood glucose were normal and comparable(P>0.05).2.Univariate analysis of curative effect showed that there was no difference in PUSH score between the two groups before and after oneweek of treatment.Statistical significance(t=0.818,P>0.05;t=0.254,P>0.05)was significant after 2 weeks of treatment(t=-2.192,P< 0.05),and there was significant difference after 4 weeks of treatment(t=-3.54,P<0.05).There was no significant difference in the area of pressure ulcer between the two groups before treatment,1 week and 2 weeks after treatment(P>0.05),but there was significant difference after 4 weeks of treatment(t=-2.578,P<0.05).There was no significant difference in wound healing rate between the two groups after 1 and 2 weeks of treatment(P>0.05).After 4 weeks of treatment,there was significant difference in wound healing rate between the two groups(t=2.511,P<0.05).There was no significant difference in therapeutic effect between the two groups(P>0.05).There were significant differences in PUSH scores between the observation group and the control group at different time points(P<0.05),that is,with the increase of treatment time,PUSH scores of patients decreased significantly;the area of pressure sores in patients at different time had significant difference(F=9.637,P<0.05);the healing effect of wounds in patients treated for one week,two weeks and four weeks had significant difference(t=-2.741,P< 0.05).That is,the wound healing rate increased significantly with the increase of treatment time.(3)Multivariate analysis of the curative effect of two groups showed that there was interaction between treatment time and group(F=6.391,P<0.05).That is to say,the change range of PUSH score between observation group and control group was related to treatment time,and treatment time had significant influence on PUSH score(F=115.902,P<0.05).There was no significant difference in PUSH score between different groups(F=2.210,P>0.05).There was no interaction between treatment time and group(F=1.103,P> 0.05),that is to say,the change of pressure ulcer area in observation group and control group could not be determined for the time being;treatment time had a significant impact on the results of pressure ulcer area(F=55.915,P<0.05);there was no significant difference in pressure ulcer area between the two groups(F=0.4771,P> 0.05).There was no interaction between treatment time and group(F=0.030,P>0.05);the healing rate of wounds in one and two weeks of treatment was different(F=63.223,P<0.05);the healing rate of wounds in observation group and control group had no difference(F=1.588,P>0.05).CONCLUSION: Sulfadiazine Silver cream combined with Yunnan Baiyao powder can reduce PUSH score more quickly than sulfadiazine silver cream combined with MEBO in the treatment of stage 3 pressure ulcers.The curative effect of stage 3 pressure ulcer is related to the treatment time.The area of pressure ulcer,healing rate of pressure ulcer and therapeutic effect did not show significant difference in a short time(2 weeks),but after 4 weeks of treatment,the effect of the observationgroup was better than that of the control group.