自体邮票植皮术联合冲洗治疗在烧伤患者中的疗效观察  

Effect of stamp skin grafting combined with irrigation therapy in burn patients

作　　者：郑刚 谢志 黄涛[1] 谷才之 Zheng Gang;Xie Zhi;Huang Tao;Gu Caizhi(Department of Burns, Eight Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China;Department of Pharmacy, General Hospital of Xinjiang Military Region, Urumqi 830000, China)

机构地区：[1]新疆医科大学第八附属医院烧伤科,乌鲁木齐830000 [2]新疆军区总医院药剂科,乌鲁木齐830000

出　　处：《中华损伤与修复杂志（电子版）》2022年第2期141-144,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的分析自体邮票植皮术联合冲洗治疗在深度烧伤患者中的治疗效果。方法选取新疆医科大学第八附属医院2015年1月至2019年1月收治的68例大面积烧伤患者,随机数字表法分为2组:对照组与观察组,每组34例。对照组Ⅰ期行清创削痂手术、自体邮票植皮术治疗;观察组在此基础上每日联合进行创面冲洗治疗持续至自体邮票植皮术手术前夕,后行邮票植皮术,观察2组手术时间,Ⅰ期创面愈合率、康复率,以及创面分泌物细菌培养阳性率,术后3、7、15 d植皮成活率以及创面愈合时间,评估患者治疗前、治疗后3个月以及治疗后6个月视觉模拟评分法(VAS)评分。数据比较采用t检验。结果观察组手术时间[(70.31±7.69)min]略长于对照组[(66.52±8.41)min],差异无统计学意义(t=1.939,P>0.05),观察组Ⅰ期创面愈合率、康复率[(77.34±7.05)%、(74.27±5.84)%]明显高于对照组[(65.61±6.92)%、(63.41±3.35)%],且创面分泌物细菌培养阳性率[(21.19±4.42)%]低于对照组[(64.36±11.25)%],差异均有统计学意义(t=6.924、9.406、20.826,P<0.05)。术后3、7、15 d,观察组植皮存活率[(34.11±5.26)%、(59.31±4.72)%、(3.19±1.42)%]均高于对照组[(28.64±11.45)%、(51.74±5.68)%、(64.71±8.25)%],差异均有统计学意义(t=2.531、5.977、3.717,P<0.05),且观察组创面愈合时间[(3.19±1.42)d]短于对照组[(5.36±2.25)d],差异有统计学意义(t=4.756,P<0.05)。治疗前2组VAS评分差异无统计学意义(P>0.05),治疗后3个月、6个月,观察组VAS评分[(5.41±0.34)、(3.35±1.09)分]分别低于对照组[(6.15±1.28)、(4.37±1.24)分],差异均有统计学意义(t=3.258、3.603,P<0.05)。结论大面积烧伤患者应用邮票植皮术联合进行创面冲洗治疗可有效改善手术指标,提高植皮存活率,对疼痛缓解也有一定帮助。Objective To analyze the effect of stamp skin transplantation combined with irrigation therapy in the treatment of deep burn patients. Methods A total of 68 patients with large-area burns were enrolled in Eight Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2019. They were divided into two groups: the control group and the observation group,with each group had 34 cases,according to the random number table. The control group was treated with debridement and escharectomy (stage Ⅰ),and stamp skin grafting,the observation group was combined with irrigation therapy every day until the eve of stamp skin grafting and then stamp skin grafting on this basis. The operation time,wound healing rate (stage Ⅰ),recovery rate,positive rate of bacterial culture of wound secretion,survival rate of skin graft and wound healing time at 3,7 and 15 days after operation were observed,visual analogue scale (VAS) scores were assessed before treatment,3 months after treatment and 6 months after treatment. Data was processed with t test. Results The operation time of the observation group[ (70. 31 ± 7. 69) min] was slightly longer than that of the control group[ (66. 52 ± 8. 41) min],there was no statistically significant difference (t = 1. 939,P > 0. 05);The wound healing rate and recovery rate in the observation group[ (77. 34 ±7. 05) %, (74. 27 ± 5. 84) %] were significantly higher than those [ (65. 61 ± 6. 92) %, (63. 41 ±3. 35) % ] in the control group,and the positive rate of bacterial culture in wound secretion[ (21. 19 ±4. 42) %] was significantly lower than that in the control group[ (64. 36 ± 11. 25) % ],the differences were statistically significant (t = 6. 924,9. 406,20. 826;P < 0. 05). At 3,7,15 days after operation,the survival rates of skin graft in the observation group [ (34. 11 ± 5. 26) %, (59. 31 ± 4. 72) %, (3. 19 ± 1. 42) %]were higher those in the control group[ (28. 64 ± 11. 45) %, (51. 74 ± 5. 68) %, (64. 71 ±8. 25) % ],the differences were statistically significant

关 键 词：烧伤 邮票植皮 冲洗治疗 创面愈合 清创术 

分 类 号：R47[医药卫生—护理学]