大面积深度烧伤患者Meek植皮术后血糖水平对手术效果的影响:基于倾向性评分匹配的回顾性研究  

Influence on the operative effect of blood glucose level after Meek skin grafting in patients with large area and deep burn:a retrospective research based on propensity score matching

作　　者：黄仕光 谢宇 杜大维 HUANG Shi-guang;XIE Yu;DU Da-wei(Department of Bum and Plastic Surgery,Guangxi Guidong People's Hospital,Wuzhou 543001,Guangxi,China)

机构地区：[1]广西桂东人民医院烧伤整形外科,广西梧州市543001

出　　处：《广西医学》2022年第19期2226-2230,共5页Guangxi Medical Journal

基　　金：广西贺州市科学研究与技术开发计划项目(贺科转1809019)。

摘　　要：目的探讨大面积深度烧伤患者Meek植皮术后血糖水平对手术效果的影响。方法回顾性分析接受Meek植皮术治疗的166例大面积深度烧伤患者的临床资料。根据术后1 d的随机血糖水平将患者分为对照组(n=62)和高血糖组(n=104),采用倾向性评分匹配法对两组患者的基线资料进行1∶1匹配。记录患者的皮片融合时间、全身创面愈合时间、术后随访12个月时的皮片存活率及疗效。结果经过倾向性评分匹配后,共有120例患者匹配成功,对照组和高血糖组各60例。匹配后,对照组皮片融合时间、全身创面愈合时间短于高血糖组,皮片存活率高于高血糖组,疗效优于高血糖组(均P<0.05)。结论大面积深度烧伤患者Meek植皮术后高水平血糖会影响移植皮片融合,造成创面愈合困难,导致皮片存活率低,手术疗效欠佳。因此,临床上除了关注大面积深度烧伤患者早期应激性血糖升高,还应重视术后血糖的监测,术后患者控制血糖水平有助于提升Meek植皮术的治疗效果。Objective To explore the influence on the operative effect of blood glucose level after Meek skin grafting in patients with large area and deep burn.Methods The clinical data of 166 patients with large area and deep burn receiving Meek skin grafting were retrospectively analyzed.The patients were assigned to control group(n=62)or hyperglycemia group(n=104)according to random blood glucose level 1 day after operation,and the propensity score matching method was used to match the baseline data of the two groups at a 1∶1 ratio.The flap fusion time,time to wound healing of whole body,and survival rate of flap and efficacy of 12-month follow-up after operation in patients were observed.Results After propensity score matching,a total of 120 patients were successfully matched,with 60 cases in the control group and 60 cases in the hyperglycemia group.After matching,the flap fusion time,and time to wound healing of whole body in the control group were shorter than those in the hyperglycemia group,the survival rate of flap was higher in the control group than in the hyperglycemia group,and the efficacy of the control group was superior to that of the hyperglycemia group(all P<0.05).Conclusion The high level of blood glucose after Meek skin grafting in patients with large area and deep burn can affect flap fusion,cause difficulty in wound healing,and lead to low survival rate of flap and poor operative efficacy;therefore,except for paying attention to the early stress blood glucose elevation in patients with large area and deep burn,it is also necessary to pay attention to the monitoring of blood glucose after operation.Controlling the blood glucose level in patients after operation is helpful to improve the therapeutic effect of Meek skin grafting.

关 键 词：烧伤 深度 大面积 MEEK植皮术 术后血糖 治疗效果 倾向性评分匹配 

分 类 号：R644[医药卫生—外科学]