湿润烧伤膏治疗大于50%TBSA临床研究报告(一)  

Clinical research on MEBO for treating bums with an area over 50% TBSA Report Ⅰ

作　　者：中国中西医结合学会烧伤专业委员会临床专题研究小组 张向清 萧摩 罗成群 王广顺 李春满 赵贤忠 姜月虎 李培富 段砚方 张勇 刘文通 李义鹏 李永忠 陈开翠 方进勇 

出　　处：《中国烧伤创疡杂志》2005年第3期169-177,共9页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的:通过对国内12所烧伤治疗具有较大影响力的三级医院治疗大面积烧伤病例分层抽样方法调查分析,进一步验证烧伤湿性医疗技术(MEBT/MEBO)治疗大面积烧伤及全身各部位烧伤创面的疗效,考察其有效性、可行性、安全性,规范MEBT/MEBO技术操作规程。方法:对回收调查表格进行逻辑校对,最终确定的60例大面积烧伤病人各部位的不同深度烧伤创面,全程采用MEBT/MEBO治疗和全身系统治疗措施治疗,全面观察、记录全身病理生理指标与创面各项指标的变化。结果:致伤原因以沸水、火焰居多;受伤部位遍布全身各处;成年组51例,烧伤总面积71.6±15.0%TBSA,小儿组9例,烧伤总面积53.9±3.8%TBSA;根据1970全国烧伤会议烧伤伤情分类标准判断均属特重度烧伤;未发生严重并发症,创面感染确诊率仅占5%,有59.9%的病人的Ⅲ度创面实行了植皮手术治疗;深Ⅱ度深型和Ⅲ度浅型创面瘢痕愈合率分别为26.8%、56.6%,但它们的瘢痕增生范围与传统疗法比均有缩小,p值均<0.01;Ⅲ度深型均为非完全正常皮肤形态的愈合,无全身不良反应。结论:MEBT/MEBO治疗大面积烧伤和全身各部位烧伤的疗效显著,可降低深Ⅱ度深型和Ⅲ度浅型创面瘢痕发生率,大面积烧伤和全身各部位的烧伤创面均是MEBT/MEBO的良好适应证;Ⅲ度深型烧伤创面可借助MEBT/MEBO促进创面肉芽组织再生,后期实行植皮手术治疗,或于烧伤早期接受植皮手术治疗。Objective： Investigation and analysis of the cases of extensive burn treated with MEBT/MEBO in 12 leading hospitals in China were done using stratified samphng method, in order to further verify the efficacy, feasibility and safety of MEBT/MEBO in treating large area bum and burn wounds in different positions and to standardize the operation in applying MEBT/MEBO technology. Method： The investigation forms were checked carefully to ensure all the data used in this research were logically reliable. 60 cases of extensive burns in different positions and with different depths were selected. All these patients were treated with MEBT/MEBO in the whole treating course in association with systemic treatment. Observations were carefully done and changes in systemic patho-physiological indexes and local indexes were carefully recorded. Result： The bum wounds were mostly caused by boiling water and flame and distributed all over the body. In adult group, 51 cases had a total bum area of 71.6±15.0% TBSA. In children group, 9 cases had a total bum area of 53.9±3.8% TBSA. According to the criterion stipulated by National Conference on Burns 1970, all the patients had extraordinarily severe bum. No severe complications happened. The wound infection rate after confirmed diagnosis was only 5%. The skin grafting rate of 3^rd degree bum wounds was 59.9%. The scar formation rate after healing of deep 2^nd and superficial 3^rd degree bum wounds were respectively 26.8% and 56.6%. The hyperplastic scar area was smaller than that of conventional treatment, P＜0.01. The morphology of the skin after deep 3^rd degree bum wound healing was not completely normal. No systemic adverse reaction occurred. Conclusion： MEBT/MEBO had marked efficacy in treating large area bum in different positions of the body. It lowered scar formation rate of deep 2^nd degree and superficial 3^rd degree bum wounds. Large area bum wounds and burn wounds in different positions of the body are good indication for MEBT/MEBO. MEBT/MEBO can promote regenera

关 键 词：烧伤湿性医疗技术 烧伤湿润暴露疗法 湿润烧伤膏 烧伤 烧伤面积 烧伤深度 治疗效果 

分 类 号：R644[医药卫生—外科学]