乌司他丁联合切痂植皮术治疗重度烧伤患者的效果观察  

Therapeutic effects of ulinastatin combined with escharectomy and dermatoplasty on severe burns

作　　者：李辉[1] 冯建科[2] 张庆富[2] 陈丽[3] 何兰 邵洪波[2] 杨蒙[2] 魏伟[2] LI Hui;FENG Jianke;ZHANG Qingfu(Department of Burn and Plastic Surgery,People’s Hospital of Dingzhou City,Hebei,Dingzhou 073000,China;不详)

机构地区：[1]河北省定州市人民医院烧伤整形科,073000 [2]河北医科大学第一医院烧伤科,050031 [3]河北省保定市第五医院西药房

出　　处：《河北医药》2021年第4期568-570,574,共4页Hebei Medical Journal

摘　　要：目的探讨乌司他丁联合切痂植皮术治疗重度烧伤患者的效果。方法将2017年8月至2019年8月院接治的86例重度烧伤患者纳入研究,随机分为2组,每组43例。对照组行切痂植皮术治疗,观察组在对照组基础上联合乌司他丁治疗。对比2组植皮成活率、创面愈合时间、血清炎性因子、肝功能水平以及术后并发症情况。结果观察组植皮成活率(97.67%)高于对照组(83.72%),差异有统计学意义(P<0.05);创面愈合时间短于对照组,差异有统计学意义(P<0.05);治疗2周,观察组血清TNF-α、IL-6水平低于对照组,血清IL-10高于对照组,差异有统计学意义(P<0.05);血清ALT、AST、BUN、Cr水平低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率(4.65%)低于对照组(18.60%),差异有统计学意义(P<0.05)。结论应用乌司他丁联合切痂植皮术治疗重度烧伤可明显提高植皮成功率,抑制患者炎性反应,促进创面愈合,降低对肝功能、肾功能损害,改善患者预后。Objective To investigate the therapeutic effects of ulinastatin combined with escharectomy and dermatoplasty on severe burns.Methods Eighty-six patients with severe burns who were treated in our hospital from August 2017 to August 2019 were enrolled in the study,who were randomly divided into two groups,with 43 cases in each group.The patients in control group were treated by escharectomy and dermatoplasty,however,the patients in observation group,on the basis of control group,were treated by ulinastatin.The skin graft survival rate,wound healing time,serum inflammatory factors,liver function,and postoperative complications were observed and compared between the two groups.Results The skin graft survival rate in observation group was 97.67%,which was significantly higher than that(83.72%)in control group(P<0.05).The wound healing time in observation group was significantly shorter than that in control group(P<0.05).After 2-week treatment,the serum levels of TNF-α,IL-6,ALT,AST,BUN,Cr in observation group were significantly lower than those in control group,however,the serum levels of IL-10 were significantly higher than those in control group(P<0.05).Moreover the incidence rate of postoperative complications in observation group was 4.65%,which was significantly lower than that(18.60%)in control group(P<0.05).Conclusion The ulinastatin combined with escharectomy and dermatoplasty can significantly increase the success rate of skin grafts and inhibit the inflammatory reactions of patients with severe burn,which can promote wound healing and decrease the damage to liver function and kidney function,so as to improve the prognosis of patients.

关 键 词：重度烧伤 乌司他丁 切痂植皮术 植皮成活率 血清炎性因子 肝功能 肾功能 

分 类 号：R644[医药卫生—外科学]