异体皮移植术与延期完成异体皮移植术在大面积烧伤患者中的效果对比  

Comparison of the effect of body skin grafting and delayed body skin grafting in patients with extensive burns

作　　者：刘玉丽[1] 王剑[1] 王延金[1] 周水勇[1] 

机构地区：[1]郑州人民医院整形外科,河南郑州450003

出　　处：《中国现代医学杂志》2014年第30期64-67,共4页China Journal of Modern Medicine

摘　　要：目的对比分析延期完成异体皮移植手术与异体皮移植手术在大面积烧伤患者中的应用效果。方法62例大面积烧伤植皮患者随机分为观察组及对照组,每组各31例患者。观察组患者进行四肢切削痂后配合异体皮移植延期手术,对照组进行四肢切削痂手术与异体皮移植同期手术,对比分析两组患者单次手术时间、术中输液总量、输注浓缩红细胞的数量、植皮存活率、术后并发症发生率以及住院时间等方面的差异。结果观察组患者手术第1次手术时间为(145.6±3.85)min、输液总量(2 451.3±112.2)mL、红细胞输注数量(5.9±1.4)mL、平均住院时间(34.5±11.6)d显著少于对照组平均时间为(238.2±4.12)min、输液总量(3 482.3±105.2)mL、红细胞输注数量(8.7±1.4)mL、平均住院时间(48.6±10.8)d,差异有显著性(P<0.05)。观察组患者术后并发症发生率3.20%显著低于对照组25.80%,而植皮成活为100.00%显著高于对照组71.00%,差异有显著性(P<0.05)。两组患者治疗后纤维蛋白肽A(FPA)、可纤维蛋白单体复合物(SFMC)低于治疗前,而蛋白C抗原(PC:Ag)、抗凝血酶抗原(AT:Ag)高于治疗前,差异有显著性(P<0.05)。治疗后观察组FPA、SFMC低于对照组,而AT:Ag、PC:Ag高于治疗前,差异有显著性(P<0.05)。结论对大面积烧伤患者行延期完成异体皮移植手术可有效缩短患者手术时间及住院时间,降低患者并发症发生率,提高植皮存活率。【Objective】To investigate the application effect of the delay in completion allogeneic skin transplant surgery and skin grafting surgery in patients with extensive burns.【Methods】18 patients with large area burns skin graft patients were divided into observation group（n =9） and control group（n =9） randomly. The observation group were carried out limbs crust with allogeneic skin transplantation delayed operation. Control group were carried out crust surgery and allogeneic skin graft surgery over the same period. The difference of single operative time, intraoperative total infusion, transfusion of packed red blood cell count, skin graft survival, incidence of postoperative complications and hospital stay were compared in two groups.【Results】The level of the single operation time（145.6±3.85） min vs（238.2±4.12） min, the total infusion（2451.3±112.2） mL vs（3482.3±105.2） mL, the number of red blood cell transfusions（5.9±1.4） mL vs（8.7±1.4） mL, and the average length of stay（34.5±11.6） d vs（48.6±10.8） d in observation group were less than those in control group, the difference was statistically significant（P〈0.05）. The rate of incidence of postoperative complications of observation group was significantly lower than control group（3.20% vs25.80%）. The rate of skin graft survival of observation group was higher than those in the control group（100.00% vs71.00%）（P〈0.05）. After treatment, the FPA, SFMC of two groups were lower while AT： Ag, PC： Ag were higher than pre-treatment（P〈0.05）, FPA, SFMC in observation group were lower while AT： Ag, PC： Ag were higher than in con-trol group（P〈0.05）. 【Conclusions】It suggests that large area burn patients limbs crust with allogeneic skin transplant can effectively shorten the operation time of patients and length of stay, reduce the incidence of complications in patients, improve skin graft survival.

关 键 词：异体皮 移植 大面积烧伤 

分 类 号：R644[医药卫生—外科学]