小面积浅Ⅱ°烧伤区假上皮瘤肉芽肿样病变4例  

Pseudo epitheliomatous hyperplastic granuloma like lesions on minor superficialⅡdegree burn wounds

作　　者：陈璧[1] 徐明达[1] 朱雄翔[1] 姜笃银[1] 李学拥[1] 

机构地区：[1]第四军医大学西京医院整形外科中心烧伤外科

出　　处：《第四军医大学学报》1999年第5期423-426,共4页Journal of the Fourth Military Medical University

摘　　要：目的：探讨小面积浅Ⅱ°烧伤区发生罕见的假上皮瘤肉芽肿样病变的原因、临床、病理特征及其防治．方法：回顾分析４例（１岁～３岁）患者的临床资料、治疗效果并将样本作病理组织学检查、微生物检测．结果：活检呈假上皮瘤肉芽肿样病变，活检组织的细菌培养，检出５种细菌：金黄色葡萄球菌、绿脓杆菌、乙型链球菌，粪链球菌及弗氏枸橼酸杆菌等，多数细菌对甲氧苯青霉素耐药．４例患者经手术切除病变，游离植皮或应用万古霉素而治愈．结论：上述小面积浅Ⅱ°烧伤创面发生罕见假上皮瘤肉芽肿样病变，系因创面早期处理不当，涂用污染或不良外用药膏导致炎性增生性肉芽肿样病变，经适当外科处理及抗感染而治愈．AIM: To investigate the cause, clinical characteristics, histopathologic changes, prevention and treatment of the unusual granuloma like lesions. METHODS: The clinical data of four patients, aged 1￣3 years, were reviewed and biopsy and bacterial cultures were made. RESULTS: Histological examination revealed pseudoepitheliomatous hyperplastic granuloma like lesions. Five kinds of organisms had been isolated from the swab and biopsy tissues, namely, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Streptococcus faecalis and Citrobacter freundii. Most of them were methicillin resistant. All of the 4 cases were cured by excision of the growth and administration of vancomycin. CONCLUSION: The above mention rarely seen pseudoepitheliomatous hyperplastie grannuloma like lesions were caused by improper management of burn wound and application of contaminated or bad topical preparations or ointments. the inflammatory hyperplastic lesions can be cured by surgical excision and/or adminstration of susceptive antibiotics.

关 键 词：烧伤 假上皮瘤样增生 肉芽肿样病变 皮肤移植 

分 类 号：R644.05[医药卫生—外科学] R622.1[医药卫生—临床医学]