CN109549777B - 预防和治疗压疮的敷料 - Google Patents
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Abstract
本发明涉及一种预防和治疗压疮的敷料，所述敷料由外至内依次包括背衬层、气垫层、凝胶层和任选的药物层，所述气垫层优选为环形气袋，所述环形气袋内气体的压力等于或小于1个大气压；优选的，所述环形气袋为彼此分离排布的1‑10条，更优选的所述每条环形气袋分隔成彼此独立的2‑5个等分或不等分的隔室，且至少一个隔室内充入0.01‑0.1个大气压的氧气或臭氧，所述充入0.01‑0.1个大气压的氧气或臭氧的隔室具有1‑10个气孔，优选的所述气孔面向环形气袋圆心均匀或不均匀布置。本发明提供了一种结构简单、成本低廉的可以为压疮患者提供氧疗的敷料。
Description
技术领域
本发明属于药物领域，具体涉及一种预防和治疗压疮的敷料。
背景技术
压疮，又称褥疮、压力性溃疡，由于失去行动能力的患者长期保持相同姿势，导致受压迫的局部软组织血液动力学改变，发生了持续性的缺血、缺氧和营养代谢障碍，随之产生了组织的溃烂坏死，严重者创面可深至骨骼，且难以愈合，严重影响了患者的生存质量。
目前对于压疮的预防和治疗多采用经常性改变身体姿势或者采用气垫床、水床等避免局部组织长期受压，对于已经出现溃疡面的患处多采用手术切除溃烂组织，使用双氧水等抑菌剂清理患部以及施用其他抑菌、促进伤口愈合的药物。但患有压疮的患者往往需要长期卧床，无法避免患病部位持续受压，且患者体质普遍较差，伤口往往难以愈合。
压疮的产生原因之一是局部组织因持续性缺血，导致组织缺氧，厌氧菌在患处大量繁殖，进一步加剧了压疮的恶化，因此，氧气在压疮的出现和治疗中具有非常重要的作用。目前已经开始使用氧疗治疗压疮，如CN206434480U公开了通过在压疮的敷料中设置氧气源接口进行氧疗；CN108354951A公开了一种促进伤口愈合的富氧凝胶剂，以沙蚕血红蛋白作为携氧成分。以上压疮敷料虽然能够实现对压疮的氧疗，从而抑制厌氧菌增殖、促进压疮的愈合，但其结构复杂，携氧量少，携氧材料价格昂贵，且不易保存，无缓解患者外部压力的作用，仍然不能有效满足预防和治疗压疮的需要。
本发明即是致力于提供一种压疮预防和治疗效果更好的敷料。
发明内容
本发明的目的是提供一种预防和治疗压疮的敷料。
一方面，本发明提供一种预防和治疗压疮的敷料，所述敷料由外至内依次包括背衬层、气垫层和凝胶层。
优选的，所述气垫层为环形气袋，所述环形气袋内气体的压力小于或等于1个大气压；
优选的，所述环形气袋为彼此分离排布的1-10条；更优选的，所述每条环形气袋分隔成彼此独立的2-5个等分或不等分的隔室；优选的，至少一个隔室内充入0.01-0.1个大气压的氧气或臭氧，所述充入0.01-0.1个大气压的氧气或臭氧的隔室具有1-10个气孔，优选的，所述气孔面向环形气袋圆心均匀或不均匀布置，剩余隔室充入小于或等于1个大气压的惰性气体；优选的，剩余隔室充入小于或等于0.8个大气压的惰性气体，所述惰性气体优选为氮气或二氧化碳。
优选的，所述凝胶层为水凝胶，更优选的，所述水凝胶为壳聚糖凝胶。
再一个方面，本发明提供一种预防和治疗压疮的敷料，所述敷料由外至内依次包括背衬层、气垫层、凝胶层和药物层。
优选的，所述气垫层为环形气袋，所述环形气袋内气体的压力小于或等于或大于1个大气压；
优选的，所述环形气袋为彼此分离排布的1-10条；更优选的，所述每条环形气袋分隔成彼此独立的2-5个等分或不等分的隔室；优选的，至少一个隔室内充入0.01-0.1个大气压的氧气或臭氧，所述充入0.01-0.1个大气压的氧气或臭氧的隔室具有1-10个气孔，优选的，所述气孔面向环形气袋圆心均匀或不均匀布置，剩余隔室充入小于或等于1个大气压的惰性气体；优选的，剩余隔室充入小于或等于0.8个大气压的惰性气体，所述惰性气体优选为氮气或二氧化碳。
优选的，所述凝胶层为水凝胶，更优选的，所述水凝胶为壳聚糖凝胶。
优选的，所述药物层包含抑菌剂、止痛剂、活血药及其他有利于压疮预防和治疗的药物；
更优选的，所述抑菌剂选自：抗生素、银离子类抑菌剂、天然抑菌剂或其混合物；所述止痛剂选自局部麻醉剂；最优选的，所述抗生素选自：青霉素、头孢菌素、庆大霉素、妥布菌素等，所述银离子类抑菌剂选自纳米银，所述天然抑菌剂为蒲公英赛醇。
优选的，所述抑菌剂为抗生素与蒲公英赛醇的混合物，更优选的，所述抑菌剂为头孢菌素与蒲公英赛醇的混合物；优选的，所述头孢菌素与蒲公英赛醇的重量比为2-5：1-3；更优选的，所述头孢菌素与蒲公英赛醇的重量比为2：1。
另一个方面，本发明提供包含充入氧气或臭氧的气垫层的敷料在制备预防或治疗压疮的药物中的用途。
优选的，所述气垫层为环形气袋，所述环形气袋内气体的压力小于或等于1个大气压；
优选的，所述环形气袋为彼此分离排布的1-10条；更优选的，所述每条环形气袋分隔成彼此独立的2-5个等分或不等分的隔室；优选的，至少一个隔室内充入0.01-0.1个大气压的氧气或臭氧，所述充入0.01-0.1个大气压的氧气或臭氧的隔室具有1-10个气孔，优选的，所述气孔面向环形气袋圆心均匀或不均匀布置，剩余隔室充入小于或等于1个大气压的惰性气体；优选的，剩余隔室充入小于或等于0.8个大气压的惰性气体，所述惰性气体优选为氮气或二氧化碳。
再一个方面，本发明提供蒲公英赛醇与抗生素的组合在制备预防和治疗压疮的敷料中的用途。
优选的，所述抗生素选自：青霉素、头孢菌素、庆大霉素、妥布菌素等；更优选的，所述抗生素为头孢菌素；
优选的，所述头孢菌素与蒲公英赛醇的重量比为2-5：1-3；更优选的，所述头孢菌素与蒲公英赛醇的重量比为2：1。
本发明有益效果
本发明通过在预防和治疗压疮敷料中引入环形气垫结构，可以有效缓解身体局部组织的压力，即可有效遏制压疮的继续恶化，也可应用于压疮易发部位，避免压疮的产生。本发明预防和治疗压疮敷料中多条环形气垫及多隔室的构造还有效增加了本发明预防和治疗压疮敷料的耐压能力，即使部分结构损坏也不会明显降低敷料的整体缓冲效果。
通过在部分隔室内充入氧气或臭氧，并向心性分布开孔，可以有效的利用间隔性的肢体移动，如翻身等导致的敷料形变为压疮患处间隔性提供氧气或臭氧，保持压疮患处的富氧环境，从而可有效抑制厌氧菌的增殖，并促进压疮患处的愈合。
本发明提供氧气或臭氧的敷料采用的隔室，具有结构简单、成本低廉、无需外接设备、无需价格高昂且不易保存的携氧材料等诸多优点，利用患者肢体移动导致的敷料的形变间隔性提供氧气或臭氧，可以长时间、间隔性的为患处提供氧气或臭氧，还能有效避免氧气或臭氧的浪费。所述敷料的携氧量可以通过充氧或臭氧隔室的数量进行简单调节。从而提供了一种结构简单、成本低廉的可以为压疮患者提供氧疗的敷料。
针对压疮患者需要长期用药的特点，本发明发明人还对预防和治疗压疮敷料中抑菌剂的种类进行了筛选，并首次发现了蒲公英提取物中的蒲公英赛醇的抑菌效果，且蒲公英赛醇与抗生素，如青霉素、头孢菌素、庆大霉素、妥布菌素等联合使用时，可以有效降低抗生素的施用剂量，从而在有效抑制压疮患处细菌，促进患处愈合的同时，有效减缓或避免了因长期施药带来的细菌耐药问题，从而有利于长时间应用于压疮患者。
附图说明：
图1：包含药物层的预防和治疗压疮敷料的纵切示意图，其中1为背衬层、2为气垫层、3为凝胶层、4为药物层；
图2：环形气袋示意图，其中1为隔室，2为气孔。
具体实施方式
在下文中更详细地描述了本发明以有助于对本发明的理解。
实施例1：一种预防和治疗压疮的敷料
所述预防和治疗压疮敷料由背衬层、气垫层、凝胶层构成。所述气垫层由5条彼此分离的环形气袋组成，其中每条气袋等分为3个隔室，其中每条气袋中有1个隔室充入0.01个标准大气压的氧气，并在该隔室向心性均匀布置2个气孔，剩余隔室均充入0.8个标准大气压的氮气，所述凝胶层为壳聚糖水凝胶。
实施例2：一种防和治疗压疮的敷料
所述预防和治疗压疮敷料由背衬层、气垫层、凝胶层和药物层构成。所述气垫层由8条彼此分离的环形气袋组成，其中每条气袋不等分为3-5个隔室，其中每条气袋中有1个隔室充入0.02个标准大气压的氧气，并在该隔室向心性布置3个气孔，剩余隔室均充入0.8个标准大气压的氮气，所述凝胶层为壳聚糖水凝胶，所述药物层活性成分为重量比为2:1的头孢唑肟与蒲公英赛醇的混合物。
效果例1：蒲公英赛醇的抑菌效果
1.1实验药物：
(1)蒲公英赛醇；(2)头孢唑肟：蒲公英赛醇＝1：3；(3)头孢唑肟：蒲公英赛醇＝1：1；(4)头孢唑肟：蒲公英赛醇＝2：1；(5)头孢唑肟：蒲公英赛醇＝3：1；(6)头孢唑肟：蒲公英赛醇＝4：1；(7)头孢唑肟。
1.2实验方法
金黄色葡萄球菌(通派(上海)生物科技有限公司)；
铜绿假单胞菌(通派(上海)生物科技有限公司)；
大肠杆菌(通派(上海)生物科技有限公司)；
分别制备含128、64、32、16、8、4、2、1、0.5、0.25、0.125μg/mL的各组试验药物的琼脂培养基，将浓度为1×107CFU/mL的菌株多点接种于琼脂培养基表面，37℃有氧条件下，培养24h，其中肉眼未见细菌生长的琼脂培养基的相应药物的浓度即为该药物的最低抑菌浓度，具体实验结果见表1。
1.4实验结果
表1蒲公英赛醇及其混合物的最小抑菌浓度(μg/mL)
| 组别 | 金黄色葡萄球菌 | 铜绿假单胞菌 | 大肠杆菌 |
| 1 | 64 | --- | 32 |
| 2 | 64 | 128 | 32 |
| 3 | 16 | 16 | 8 |
| 4 | 8 | 16 | 8 |
| 5 | 16 | 32 | 8 |
| 6 | 32 | 16 | 8 |
| 7 | 16 | 16 | 8 |
其中---表示肉眼未观察到未见细菌生长的琼脂培养基。
表1实验结果显示了蒲公英赛醇对金黄色葡萄球菌和大肠杆菌的最小抑菌浓度均小于128μg/mL，显示了明显的抑菌效果。
将蒲公英赛醇与头孢唑肟复配后，因配比的不同显示了明显不同的抑菌效果，头孢唑肟：蒲公英赛醇＝1：3时，对金黄色葡萄球菌和大肠杆菌的抑菌效果与单独的蒲公英赛醇相当，但弱于头孢唑肟的抑菌效果，对铜绿假单胞菌的抑制效果相对于单独的蒲公英赛醇有所提高，与单独的头孢唑肟效果相当。
头孢唑肟：蒲公英赛醇＝1：1、2：1或3：1时，头孢唑肟与蒲公英赛醇复配物的抑菌效果具有明显的提升，在头孢唑肟用量降低的情况，混合物仍然显示了与头孢唑肟相当甚至更优的抑菌效果，显示了蒲公英赛醇具有降低头孢唑肟最小抑菌浓度的效果。
以上描述了本发明优选实施方式，然其并非用以限定本发明。本领域技术人员对在此公开的实施方案可进行并不偏离本发明范畴和精神的改进和变化。
Claims (1)
1.一种预防和治疗压疮的敷料，其特征在于，所述预防和治疗压疮敷料由背衬层、气垫层、凝胶层和药物层构成,所述气垫层由8条彼此分离的环形气袋组成,其中每条气袋不等分为3-5个隔室,其中每条气袋中有1个隔室充入0.02个标准大气压的氧气,并在该隔室向心性布置3个气孔,所述气孔面向环形气袋圆心均匀或不均匀布置，剩余隔室均充入0.8个标准大气压的氮气,所述凝胶层为壳聚糖水凝胶,所述药物层活性成分为重量比为2:1的头孢唑肟与蒲公英赛醇的混合物。
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