深Ⅱ度烧伤创面伤后不同手术时期行切削痂植皮术的临床疗效比较  

Impact of excision of eschar plus skin grafting time in patients with deep second degree burn

作　　者：周丽娜[1] 张斌杰[1] Zhou Lina;Zhang Binjie(Department of Orthopedics,Yan＇an People＇s Hospital,Yan＇an 716000,China)

机构地区：[1]陕西省延安市人民医院骨科四病区,延安716000

出　　处：《广西医科大学学报》2018年第9期1237-1240,共4页Journal of Guangxi Medical University

摘　　要：目的:探讨深Ⅱ度烧伤创面伤后不同手术时期行切削痂植皮术的临床疗效。方法:选取2016年10月至2017年2月陕西省延安市人民医院收治的80例深Ⅱ度烧伤创面伤患者,按手术时机不同分为对照组(烧伤3~5d行切削痂植皮术治疗,n=38)和研究组(伤后24h内施行切削痂植皮术治疗,n=42),观察治疗前、后两组血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]水平。比较两组一次性植皮成活率、创面愈合时间、发热持续时间、住院时间、治疗总有效率及并发症发生率。结果:治疗后第1、第5天,研究组IL-6、IL-10、TNF-α明显低于对照组(P<0.05);研究组一次性植皮成活率高于对照组(P<0.05);研究组创面愈合时间、发热持续时间、住院时间明显短于对照组(P<0.05);研究组治疗总有效率明显高于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:烧伤后24h内为深Ⅱ度烧伤创面伤患者实施切削痂植皮术,更利于患者快速康复,效果更为明显。Objective： To compare the clinical effects between different eschar excision plus skin grafting time in patients with deep II degree burn.Methods： A total of 80 patients with deep II degree burn treated in the hospital from October 2016 to February 2017 were selected,and divided into a control group （eschar excision plus skin grafting after 3 to 5 days of burn, n =38） and a study group （eschar excision plus skin grafting within 24 h after burn, n =42）.Serum levels of inflammatory factors [interleukin-6 （IL-6）,interleukin -10 （IL-10）,tumor necrosis factor α （TNF-α）] were detected before and after treatment.The survival rate of one-time skin grafting,wound healing time,duration of fever,hospital stay,the total response rate and the incidence of complications were compared between the two groups. Results： The levels of IL-6,IL-10 and TNF-α in the study group on the 1 st day and the 5 th day after treatment were significantly lower than those in the control group （ P 〈0.05）.The survival rate of one-time skin grafting in the study group was higher than that in the control group,while the wound healing time,the duration of fever and hospital stay were significantly shorter than those of the control group （ P 〈0.05）.After treatment,the total response rate of the study group was significantly higher than that of the control group （ P 〈0.05）,while the incidence of complications was markedly lower （ P 〈0.05）.Conclusion： The application of eschar excision plus skin grafting in the treatment of patients with deep II degree burn within 24 h after burn was more effective and more favorable for the recovery of patients.

关 键 词：深Ⅱ度烧伤 创面伤 手术时期 切削痂植皮术 不同时期 临床疗效 

分 类 号：R644[医药卫生—外科学]