人工真皮联合自体薄皮片移植和自体中厚皮移植治疗烧伤后增生性瘢痕的疗效比较  

Comparison of Effificacy of Artifificial Dermis Combined with Autologous Thin-split Skin Grafts or Autologous Mid-thickness Skin Grafts in the Treatment of Hypertrophic Scars after Burn Injury

作　　者：王丽英[1] 黄红军[1] 牛希华[1] WANG Li-ying;HUANG Hong-jun;NIU Xi-hua(Wound repair division, The medical group of Zhengzhou first people's hospital, Henan Province, 453000, China)

机构地区：[1]郑州市第一人民医院创面修复科,河南郑州453000

出　　处：《中国医疗美容》2018年第2期26-29,共4页China Medical Cosmetology

摘　　要：目的人工真皮联合自体薄皮片移植和自体中厚皮移植治疗烧伤后增生性瘢痕(HS)的疗效比较。方法对我院66例烧伤后HS患者临床资料进行回顾性分析,根据其治疗方案分为人工真皮+自体薄皮片移植组(研究组,n=31)和自体中厚皮移植组(对照组,n=35)。观察自体皮成活率、感染率,于术前(T1)及术毕3个月后(T2)评估2组患者生存质量[烧伤患者健康精简量表(BSHS-B)]和心理状态[简明心境问卷(POMS-SF)],于T2时评估瘢痕情况[温哥华瘢痕量表(VSS)]。结果 2组自体皮成活率、感染率无明显差异(P>0.05)。T2时,2组BSHS-B评分均较T1时上升,POMSSF评分则均较T1时降低,且研究组变化幅度大于对照组(P<0.05);2组瘢痕组织色泽、柔软度评分无明显差异(P>0.05);研究组厚度、血管分布评分显著低于对照组(P<0.05)。结论人工真皮联合自体薄皮片移植和自体中厚皮移植在烧伤后HS治疗中均可取得良好效果,人工真皮联合自体薄皮片移植在改善HS患者生存质量、心理状态及瘢痕厚度、血管分布等方面更具优势。Objective To compare the efficacy of artificial dermis combined with autologous thin-split skin grafts or autologous mid-thickness skin grafts in the treatment of hypertrophic scars(HS)after burn injury.Methods The clinical data of66HS patients after burn injury in our hospital were retrospectively analyzed.According to the treatment regimens,they were divided into artificial dermis and autologous thin-spilt skin grafts group(study group,n=31)and autologous mid-thickness skin grafts group(controlgroup,n=35).The autologous skin survival rate and infection rate were observed,and quality of life[burn specific health scale-brief(BSHS-B)]and psychological state[Profile of Mood States-Short Form(POMS-SF)]were evaluated in two groups before operation(T1)and at3months after operation(T2),and the scar condition[Vancouver scar scale(VSS)]was assessed at T2.Results There was no significant difference in autologous skin survival rate and infection rate between two groups(P>0.05).At T2,the score of BSHS-B in two groups was increased compared with that at T1while POMS-SF score was decreased compared with that at T1,and the changes degree in study group was higher than that in control group(P<0.05).There was no significant difference in scar color and softness scores between the two groups(P>0.05).The scores of thickness and vascular distribution in study group were significantly lower than those in control group(P<0.05).Conclusions Artificial dermis combined with autologous thin-spilt skin grafts or autologous mid-thickness skin grafts both can achieve good effects in the treatment of HS after burn injury.Artificial dermis combined with autologous thin-spilt skin grafts is more advantageous in improving the quality of life,psychological status,scar thickness and vascular distribution of HS patients.

关 键 词：人工真皮 自体薄皮片 自体中厚皮 移植 增生性瘢痕 

分 类 号：R622[医药卫生—整形外科]