MEBO治愈1例下肢慢性溃疡恶变报告  

MEBO Curing Malignant Transformation of Chronic Lower Limb Ulcer:A Case Report

作　　者：陈方凯 龚海粟 

机构地区：[1]福安市医院,福建福安355001

出　　处：《中国烧伤创疡杂志》2013年第3期233-236,共4页The Chinese Journal of Burns Wounds & Surface Ulcers

摘　　要：目的观察湿润烧伤膏(MEBO)在下肢慢性溃疡恶变中的治疗效果。方法患者入院后,对创面予以病理活检、微生物培养、摄片等检查后,对创面局部纤维板给予划开清除,逐层削除老化、纤维化肉芽组织,使创面形成相对"新鲜"状态后,采用MEBO换药治疗(每6 h换药1次),重新培育肉芽组织;全身给予抗感染、改善微循环等治疗。创面肉芽组织成熟后,再次多点活检病理检查,确认创面无明显癌组织后,行"邮票式"植皮手术、周围曲张静脉结扎及分段剥脱术,供皮区使用MEBO油纱换药治疗;术后5 d,植皮区改用MEBO油纱包扎换药治疗,每日1次,直至创面完全愈合。结果供皮区创面于术后14 d愈合,植皮区创面于术后30 d痊愈,愈后随访4年,创面轻度瘢痕增生,无新的溃疡创面形成及转移癌发生。结论 MEBO是肉芽组织生长的"培养基",能促进慢性溃疡创面的愈合,是慢性溃疡创面修复的良好外用药。另外,MEBO可能影响体表肿瘤的生物特性,抑制肿瘤细胞生长。Objective To observe the efficacy of MEBO in treating malignant transformation of chronic lower limb ulcer. Methods After admission, the wound was examined by pathological biopsy, microbial culture, and imaging. Per form excision on the local wound fibreboard, excising degenerated and fibrotic granulation tissues layer by layer, exposing the ＂fresh＂ wound surface. Then apply MEBO on the wound and change dressing once every 6 hours, cultivating new granu lation tissue; systemic anti-infection and microcirculation improvement therapy were performed. When wound granulation tissue matured, multiple site pathological biopsy exam was taken to confirm there was no obvious wound tissue caneeration. Then perform ＂stamp＂ skin grafting and peripheral varicose ligation ＆ segmented peeling surgery; the donor site wound was treated with MEBO gauze dressing change. Five days post operation, wound at skin grafting site was treated with bandaged MEBO gauze dressing change once a day till complete wound healing. Results Wounds of donor sites healed 14 days after operation and wounds of skin grafting healed 30 days after operation. Four-year follow-up after wound healing found mild proliferation of scar but no new ulceration or metastatic cancer. Conclusion MEBO Ointment is the ＂culture medium＂ pro moting the growth of granulation tissue and can promote the healing of chronic ulcers, and thus is an excellent external drug for wound repair of chronic ulcer. Moreover, MEBO Ointment may influence the biological features of superficial tumor, in hibiting the growth of tumor cells.

关 键 词：湿润烧伤膏 下肢慢性溃疡 恶变 治疗 

分 类 号：R269[医药卫生—中西医结合]