水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶治疗新生儿尿布性皮炎的临床观察

王宁 王小虎

[摘要] 目的 观察水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶在新生儿尿布性皮炎中的治疗效果。方法 采用水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶治疗新生儿尿布性皮炎96例，患儿均来自淄博市中心醫院 2018年9月～ 2019年9月收治病例，患儿依随机数字表法分为观察组、对照组各48例，观察组创面采用水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶应用，对照组予以常规外科换药，比较两组的临床疗效，包括有效率、尿布性皮炎消退时间及不良事件发生率。 结果 观察组治疗的总有效率（91.67%）明显高于对照组（64.58%），差异有统计学意义（P<0.05）。观察组的轻度、中度、重度患儿治愈率（分别为93.10%，91.67%，85.71%）明显高于对照组轻度、中度、重度组（分别为75.00%，57.14%，33.33%），差异有统计学意义（P值分别为0.041，0.033，0.023）。观察组的治疗时间为（93.26±21.83）h，明显短于对照组（112.39±48.25）h，差异有统计学意义（P<0.05）。观察组的不良反应发生率（6.25%）明显低于对照组（22.92%），差异有统计学意义（P<0.05），提示水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶治疗尿布性皮炎较常规疗法疗效为佳。结论 水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶对新生儿尿布性皮炎疗效显著，同常规换药相比，可有效消除皮损症状，加快皮肤愈合，减少不良事件发生，值得临床中推广应用。

[关键词] 水胶体敷料;重组牛碱性成纤维细胞生长因子外用凝胶;新生儿;尿布性皮炎

[中图分类号] R758.2          [文献标识码] B          [文章编号] 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.

本研究对96例尿布性皮炎患儿进行前瞻性治疗观察，同常规治疗方法进行对比并统计学分析，探讨水胶体敷料联合贝复新在尿布性皮炎治疗中的应用。研究结果显示：观察组治疗总有效率（91.67%）明显高于对照组（64.58%），差异有统计学意义。观察组患者的轻度、中度、重度患儿治愈率均明显高于对照组。观察组患者的治疗时间为（93.26±21.83）h，明显短于对照组（112.39±48.25）h。观察组的不良反应（6.25%）明显少于对照组（22.92%），提示水胶体敷料联合重组牛碱性成纤维细胞生长因子外用凝胶治疗尿布性皮炎较常规疗法疗效为佳。原理分析，考虑重组牛碱性生长因子通过水胶体敷料的特有吸收能力和通透性，从而可更好的附着于创面，促进创面愈合，二者联合应用能更加有效地发挥其作用特点，从而增强治疗效果。值得注意的是，三分治疗七分护理，对于新生儿尤其如此，新生儿皮肤娇嫩，良好的医疗护理操作在治疗新生儿尿布性皮炎中也占据重要作用，耐心的病情沟通对于家长配合度的提升也起到了促进作用[16]。

本研究存在一定局限性和不足：首先本研究是单中心研究，其次，受患者例数及规模所限，未能与其他治疗方法如氧疗、湿润烧伤膏等药物进行疗效对比，希望能在进一步研究中完善。

综上所述，本研究结果显示：水胶体敷料联合贝复新对新生儿尿布性皮炎疗效显著，同常规换药相比，可有效消除皮损症状，加快皮肤愈合，减少不良事件发生，值得临床中推广应用。

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（收稿日期：2020-03-27）