新型生物敷料结合VSD对II度烧伤创面恢复及炎性应激反应的影响  

Effect of New Biological Dressing Dombined with VSD on Wound Recovery and Inflammatory Stress Response of Degree-II Burn

作　　者：成鑫 汤俊[1] CHENG Xin;TANG Jun(Department of Burn Surgery,Huangshi city,the Fifth Hospital of Hubei Province,Huangshi 435005,China)

机构地区：[1]湖北省黄石市第五医院烧伤外科,湖北黄石435005

出　　处：《药物生物技术》2020年第1期52-55,共4页Pharmaceutical Biotechnology

摘　　要：评价II度烧伤患者实施新型生物敷料结合负压封闭引流(VSD)治疗对其创面恢复、炎性因子及应激反应的影响,以指导临床合理治疗。根据随机双盲试验将2016年8月至2019年2月来该院就诊的124例II度烧伤患者分为两组,各62例。所有患者完成创面清洗后,均接受VSD技术封闭创面,对照组覆盖普通油纱(凡士林油纱),观察组覆盖新型生物敷料(异种脱细胞真皮基质敷料)。对比两组创面愈合情况、水疱发生率、炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、应激反应[肾上腺素(E)、去甲肾上腺素(NE)、肾素(R)]及不良反应。结果显示:观察组水疱发生率(6.45%)比对照组(19.35%)低,治疗d 10、d 15的温哥华瘢痕量表(VSS)评分及静息时视觉模拟评分量表(VAS)评分比对照组低,愈合时间比对照组短,差异有统计学意义(P<0.05);观察组治疗d 15的IL-6、TNF-α、CRP水平及NE、E、R水平均比对照组低,差异有统计学意义(P<0.05);治疗期间仅对照组出现1例感染。给予II度烧伤患者新型生物敷料结合VSD治疗可促进其创面快速愈合,减少创面瘢痕增生,减轻静息状态下疼痛程度,降低炎性应激反应,且无明显不良反应。To evaluate the effect of new biological dressing combined with vacuum sealing drainage(VSD)on wound recovery and inflammatory stress response of degree-II burn,and to provide guidance for clinical reasonable treatment,124 patients with degree-II burn in the hospital from August 2016 to February 2019 were divided into two groups by randomized double blind method,with 62 cases in each group.All patients were given wound cleaning,and they received wound sealing with VSD technology.Control group was given conventional oil gauze covering(Vaseline gauze),and observation group was given new biological dressing(heterogeneous acellular dermal matrix dressing).The wound healing,incidence of blister,inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],stress response[epinephrine(E),norepinephrine(NE),renin(R)],adverse reactions were compared between two groups.The incidence of blister in observation group(6.45%)was lower than that in control group(19.35%),the scores of Vancouver scar scale(VSS)after treatment for 10 d and 15 d and the resting visual analogue scale(VAS)in observation group were lower than those in control group,and the healing time of observation group was shorter than that of control group(P<0.05).After treatment for 15 d,the levels of IL-6,TNF-α,CRP,NE,E,R in observation group were lower than those in control group(P<0.05).There was only 1 case of infection in control group during treatment.New biological dressing combined with VSD for patients with degree-II burn can promote wound healing,reduce wound scar hyperplasia,decrease resting pain degree,reduce inflammatory stress response,and have no obvious adverse reactions.

关 键 词：Ⅱ度烧伤 新型生物敷料 负压封闭引流技术 创面恢复 炎性因子 应激反应 

分 类 号：R466[医药卫生—临床医学]