应用负压治疗技术修复小儿浅Ⅱ度烫伤创面的效果观察  

Efficacy observation on application of negative pressure therapy in the treatment of superficial partial-thickness scald wound in children

作　　者：申传安[1] 柴家科[1] 庹晓晔[1] 蔡建华[1] 李东杰[1] 张琳[1] 朱华[1] 蔡金东[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100048

出　　处：《中华烧伤杂志》2013年第1期14-17,共4页Chinese Journal of Burns

基　　金：军队＂十二五＂面上项目,首都临床特色应用研究（Z12110700102092）

摘　　要：目的 观察应用负压治疗技术修复小儿浅Ⅱ度烫伤创面的效果. 方法 将2009年8月-2012年5月笔者单位收治的307例浅Ⅱ度烫伤患儿按照随机数字表法进行分组,负压治疗组145例、对照组162例.负压治疗组患儿于伤后72 h内进行负压治疗（压力为-16 kPa）,伤后第9天结束；对照组患儿采用传统的包扎换药方式治疗.对比2组患儿治疗过程中的体温变化、创面修复情况及换药次数；对比负压治疗组治疗前后的创面细菌培养情况,记录负压治疗组治疗后1、2、3d每百分之一烫伤面积的引流液量.数据比较行t检验或x2检验. 结果 负压治疗组患儿出现发热的比例为26.9％ （39/145）,显著低于对照组[63.6％ （103/162）,x2 =41.419,P＜0.01].伤后第9天,负压治疗组138例患儿的创面完全上皮化愈合,7例零星残余创面经碘伏消毒换药后2d愈合.负压治疗组创面愈合时间为（9.2±0.6）d,明显短于对照组[（10.1±1.6）d,t=6.895,P＜0.01].负压治疗组患儿的换药次数为（2.05±0.22）次,显著少于对照组[（4.82±0.81）次,t=39.878,P＜0.01].负压治疗组治疗前,17例创面分泌物细菌培养结果呈阳性；治疗后,7例未愈创面分泌物细菌培养结果均为阴性.负压治疗组引流液量与创面大小成正比,治疗后第1、2、3天每百分之一烫伤面积引流液量分别为（9.8±3.2）、（6.2±2.1）、（4.1±1.6）mL. 结论 负压治疗可显著减少换药次数,通过引流创面渗液减轻感染和炎症反应进而促进创面愈合,是治疗小儿浅Ⅱ度烫伤的安全有效方法.Objective To observe the effect of negative pressure therapy in the treatment of superficial partial-thickness scald in children.Methods Three hundred and seven children with superficial partial-thickness scald hospitalized from August 2009 to May 2012 were divided into negative pressure therapy group （NPT,n =145） and control group （C,n =162） according to the random number table.Patients in group NPT were treated with negative pressure from within post injury day （PID） 3 to PID 9 （with-16 kPa pressure）,while traditional occlusive dressing method was used in group C.Changes in body temperature,wound healing condition,frequency of dressing change were compared between group NPT and group C.Bacterial culture results of wounds were compared before and after treatment in group NPT.Volume of drained transudate per one percent of wound area was recorded in group NPT on PID 1 to PID 3.Data were processed with t test or chi-square test.Results The incidence of high fever was significantly lower in group NPT （26.9％,39/145） than in group C （63.6％,103/162,x2 =41.419,P ＜0.01）.On PID9,complete wound epithelization was observed in 138 patients in group NPT,and in 7 patients there were a few residual wounds which healed after dressing change for 2 days.The wound healing time of patients in group NPT [（9.2 ±0.6） d] was obviously shorter than that in group C [（10.1 ±1.6） d,t =6.895,P ＜0.01].The frequency of dressing change among patients in group NPT [（2.05 ± 0.22） times] was significantly decreased as compared with that in group C [（4.82 ± 0.81） times,t =39.878,P ＜ 0.01].Bacteria were found in wound secretion of seventeen patients in group NPT before treatment,while no bacterium was discovered in all patients after treatment.Volumes of drainage fluid in group NPT were proportional to wound areas,which were respectively （9.8 ± 3.2）,（6.2 ± 2.1）,（4.1 ± 1.6） mL per one percent of wound area on PID 1,2,and 3.Conclusions NPT can decrease times of dressing change,and a

关 键 词：烧伤 负压伤口疗法 儿童 创面修复 

分 类 号：R726[医药卫生—儿科]