王寧 王小虎

[摘要] 目的 觀察水膠體敷料聯(lián)合重組牛堿性成纖維細胞生長因子外用凝膠在新生兒尿布性皮炎中的治療效果。方法 采用水膠體敷料聯(lián)合重組牛堿性成纖維細胞生長因子外用凝膠治療新生兒尿布性皮炎96例，患兒均來自淄博市中心醫(yī)院 2018年9月～ 2019年9月收治病例，患兒依隨機數(shù)字表法分為觀察組、對照組各48例，觀察組創(chuàng)面采用水膠體敷料聯(lián)合重組牛堿性成纖維細胞生長因子外用凝膠應(yīng)用，對照組予以常規(guī)外科換藥，比較兩組的臨床療效，包括有效率、尿布性皮炎消退時間及不良事件發(fā)生率。 結(jié)果 觀察組治療的總有效率（91.67%）明顯高于對照組（64.58%），差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組的輕度、中度、重度患兒治愈率（分別為93.10%，91.67%，85.71%）明顯高于對照組輕度、中度、重度組（分別為75.00%，57.14%，33.33%），差異有統(tǒng)計學(xué)意義（P值分別為0.041，0.033，0.023）。觀察組的治療時間為（93.26±21.83）h，明顯短于對照組（112.39±48.25）h，差異有統(tǒng)計學(xué)意義（P<0.05）。觀察組的不良反應(yīng)發(fā)生率（6.25%）明顯低于對照組（22.92%），差異有統(tǒng)計學(xué)意義（P<0.05），提示水膠體敷料聯(lián)合重組牛堿性成纖維細胞生長因子外用凝膠治療尿布性皮炎較常規(guī)療法療效為佳。結(jié)論 水膠體敷料聯(lián)合重組牛堿性成纖維細胞生長因子外用凝膠對新生兒尿布性皮炎療效顯著，同常規(guī)換藥相比，可有效消除皮損癥狀，加快皮膚愈合，減少不良事件發(fā)生，值得臨床中推廣應(yīng)用。

[關(guān)鍵詞] 水膠體敷料;重組牛堿性成纖維細胞生長因子外用凝膠;新生兒;尿布性皮炎

[中圖分類號] R758.2 ? ? ? ? ?[文獻標(biāo)識碼] B ? ? ? ? ?[文章編號] 1673-9701（2020）15-0076-04

Clinical observation of hydrocolloid dressing combined with topical gel of recombinant bovine basic fibroblast growth factor in treatment of neonatal diaper dermatitis

WANG Ning1 ? WANG Xiaohu2

1.Department of Burn and Wound Repair Surgery， East Branch， Zibo Central Hospital in Shandong Province， Zibo ? 276000， China; 2.Department of Neonatology， the Affiliated Hospital of Qingdao University， Qingdao ? 266000， China

[Abstract] Objective To observe the therapeutic effect of hydrocolloid dressing combined with topical gel of recombinant bovine basic fibroblast growth factor in neonatal diaper dermatitis. Methods 96 cases of neonatal diaper dermatitis who were treated with hydrocolloid dressing combined with topical gel of recombinant bovine basic fibroblast growth factor were selected. The children patients were all admitted to Zibo Central Hospital from September 2018 to September 2019. The children patients were divided into the observation group and control group by random number table method， with 48 cases in each group. The wounds in the observation group were applied with hydrocolloid dressing combined with topical gel of recombinant bovine basic fibroblast growth factor， and the control group was given routine surgical dressing change. The clinical efficacy was compared between the two groups， including the effectiveness， the resolution time of diaper dermatitis and the incidence rate of adverse events. Results The total effective rate of treatment in the observation group（91.67%） was significantly higher than that in the control group（64.58%）， and the difference was statistically significant（P<0.05）. The cure rates of mild， moderate， and severe children patients in the observation group（93.10%， 91.67%， 85.71%， respectively） were significantly higher than those in the control group（75.00%， 57.14%， 33.33%）， and the differences between both groups were statistically significant（P values were 0.041， 0.033， 0.023）. The treatment time in the observation group was（93.26±21.83） hours， which was significantly shorter than that of （112.39±48.25） hours in the control group， and the difference was statistically significant（P<0.05）. The incidence of adverse reactions in the observation group（6.25%） was significantly less than that in the control group （22.92%）， and the difference was statistically significant（P<0.05）. It was suggested that hydrocolloid dressing combined with topical gel of recombinant bovine basic fibroblast growth factor was better than conventional therapy in the treatment of diaper dermatitis. Conclusion Hydrocolloid dressing combined with topical gel of recombinant bovine basic fibroblast growth factor has a significant effect on neonatal diaper dermatitis. Compared with conventional dressing replacement， it can effectively eliminate the symptoms of skin lesions， accelerate skin healing， and reduce the occurrence of adverse events， which is worthy of clinical promotion and application.

本研究對96例尿布性皮炎患兒進行前瞻性治療觀察，同常規(guī)治療方法進行對比并統(tǒng)計學(xué)分析，探討水膠體敷料聯(lián)合貝復(fù)新在尿布性皮炎治療中的應(yīng)用。研究結(jié)果顯示：觀察組治療總有效率（91.67%）明顯高于對照組（64.58%），差異有統(tǒng)計學(xué)意義。觀察組患者的輕度、中度、重度患兒治愈率均明顯高于對照組。觀察組患者的治療時間為（93.26±21.83）h，明顯短于對照組（112.39±48.25）h。觀察組的不良反應(yīng)（6.25%）明顯少于對照組（22.92%），提示水膠體敷料聯(lián)合重組牛堿性成纖維細胞生長因子外用凝膠治療尿布性皮炎較常規(guī)療法療效為佳。原理分析，考慮重組牛堿性生長因子通過水膠體敷料的特有吸收能力和通透性，從而可更好的附著于創(chuàng)面，促進創(chuàng)面愈合，二者聯(lián)合應(yīng)用能更加有效地發(fā)揮其作用特點，從而增強治療效果。值得注意的是，三分治療七分護理，對于新生兒尤其如此，新生兒皮膚嬌嫩，良好的醫(yī)療護理操作在治療新生兒尿布性皮炎中也占據(jù)重要作用，耐心的病情溝通對于家長配合度的提升也起到了促進作用[16]。

本研究存在一定局限性和不足：首先本研究是單中心研究，其次，受患者例數(shù)及規(guī)模所限，未能與其他治療方法如氧療、濕潤燒傷膏等藥物進行療效對比，希望能在進一步研究中完善。

綜上所述，本研究結(jié)果顯示：水膠體敷料聯(lián)合貝復(fù)新對新生兒尿布性皮炎療效顯著，同常規(guī)換藥相比，可有效消除皮損癥狀，加快皮膚愈合，減少不良事件發(fā)生，值得臨床中推廣應(yīng)用。

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（收稿日期：2020-03-27）