网状皮片移植在大面积烧伤手术中的临床应用  

Value of mesh skin graft in treating patients with large area burns

作　　者：刘志勇[1] 李叶扬[1] 林伟华[1] 

机构地区：[1]暨南大学第四附属医院/广州市红十字会医院烧伤科,广东广州510220

出　　处：《广东药学院学报》2006年第6期677-679,共3页Academic Journal of Guangdong College of Pharmacy

摘　　要：目的探讨网状皮片移植在大面积烧伤患者手术中的应用。方法118例大面积重烧伤患休克期后的第1次四肢切削痂手术,随机分为两组:A组(61例)应用网状皮片的移植;B组(57例)应用大张中厚皮与邮票皮片混植加用异体覆盖术。结果(1)手术时间:A组手术时间为(4.1±1.2)h,B组手术时间(6.2±1.9)h,两组比较差异有显著性(P<0.01);(2)手术参加人员次数:A组每例参加手术人数为(5±1)人,B组每例参加手术人数为(9±1)人(P<0.01);(3)植皮成活率:A组为99.6%,B组为92.1%(P<0.05);皮下积血率:A组为0.2%,B组为6.3%(P<0.01);残创发生率:A组为1.2%,B组为8.4%(P<0.05);(4)两组术中及术后48 h内输液量和输血量比较:第1个24 h输液总量A组为(11.4±1.2)L,B组为(11.2±2.3)L(P>0.05);输血量A组为(2.4±1.0)L,B组为(2.4±1.1)L(P>0.05);第2个24 h输液总量A组为(8.9±1.4)L,B组为(9.2±1.5)L(P>0.05);输血量A组为(1.8±0.6)L,B组为(2.0±0.8)L(P>0.05);(5)远期观察疤痕增生差异无显著性。结论在烧伤早期手术中网状皮片能缩短手术时间,避免过长时间加重患者的痛苦,并能提高皮片成活率,减少皮下积血,节约手术人员的配备,明显提高效率。Objective To explore the application of mesh skin graft in treating patients with large area bums. Methods 118 patients with large area heavy burns were randomized to 2 groups after the shock stage and preparing the procedure of cutting scale, group A （61 patients） were applied with mesh skin graft, group B （57 patients） were applied with mixture of the large medi-pachydermia and stamp skin graft plus variant covered. Results （ 1 ） The timing of procedures： group A was （4.1±1.2）h, group B was （6.2 ±1.9）h, （P 〈 0.01 ）. （2） The attendance of medical staff in the procedure： group A： 5 ±1 in one operation; group B： 9 ± 1 in one operation （P 〈 0.01 ）. （3） The hematoma： group A was 0.2%, group B was 6.3%, （ P 〈 0.01 ） ; the survival rate ： group A, 99.6% ; group B, 92.1% （P〈0.05） ; the incidence of residual wound： group A, 1.2% ; group B, 8.4% （P〈0.05）. （4） There were no difference between 2 groups in scar proliferation in long - term （P 〉 0.05 ）. （5） The volume of blood transfusion during the procedures in the 2 groups was same （ P 〉 0.05 ）. Conclusion Application of mesh skin graft in early stage could reduce the procedure time, avoid aggravation of suffering in the patients due to the long time operation, increase survival rate, reduce subcutaneous hematoccle, and reduce medical staff attending the procedure with improved efficiencies.

关 键 词：烧伤 网状皮片 植皮 

分 类 号：R644[医药卫生—外科学]