伤科黄水联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化的疗效观察  

Observation on the Effect of Shangke Huangshui Combined with Artificial Dermis in the Treatment of Finger Acute Full-thickness Skin Defect

作　　者：李鲜慧 张家盛[1] 邹成友 余卓安 高峻青[1] Li Xianhui;Zhang Jiasheng;Zou Chengyou;Yu Zhuoan;Gao Junqing(The Eighth Clinical Medical College Affiliated to Guangzhou University of Chinese Medicine,Foshan City of Traditional Chinese Medicine,Guangdong,Foshan 528000,China)

机构地区：[1]广州中医药大学附属第八临床医学院,广东省佛山市中医院,广东佛山528000

出　　处：《中国中医急症》2023年第9期1587-1590,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省科学技术厅项目(2020B1111150001);广东省中医药局科研项目(20211370)。

摘　　要：目的观察伤科黄水联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化的临床效果并探讨其作用机制。方法36例患者均给予彻底清创处理并予国产人工真皮覆盖,二期去除上层硅胶膜后,观察组予伤科黄水换药治疗,对照组予常规换药,疗程为14 d并随访2个月余,观察患者伤口疼痛、肿胀、创面愈合时间及愈合质量。结果两组患者均完成全部疗程治疗和随访,无脱落及不良事件发生。两组术前VAS评分比较,差异无统计学意义(P>0.05)。两组术后7、14 d疼痛评分与术前比较均改善,且观察组优于对照组(均P<0.05)。观察组拆除硅胶膜时间、创面愈合时间和瘢痕评分均优于对照组(均P<0.05)。两组术前肿胀情况比较,差异无统计学意义(P>0.05)。观察组术后14 d肢体肿胀消退优于对照组(P<0.05)。术后两月随访,两组患者创面愈合佳,未发生明显不良反应,创面愈合情况及中医证候疗效评价,差异无统计学意义(均P>0.05)。结论伤科黄水外敷联合人工真皮治疗手指急性全层皮肤缺损创面自动上皮化疗效好,可效促进人工真皮血管化、缩短创面愈合时间,同时提高患者治疗体验,减轻瘢痕形成,提高愈合质量。Objective:To observe the clinical effect of Shangke Huangshui combined with artificial dermis in the treatment of finger acute full-thickness skin defect with automatic epithelialization.Methods:A total of 36patients with acute full-thickness skin defects of fingers were selected.All patients were thoroughly debridement and covered with domestic artificial dermis.After the upper layer of silica gel membrane was removed in the second stage,the observation group was treated with Shangke Huangshui,and the control group was treated with routine dressing change.The course of treatment was 14 days and the patients were followed for 2 months to observe wound pain,swelling,wound healing time and healing quality of the patients.Results:Both groups of patients completed the full course of treatment and were followed(for more than 2 months),and there were no dropouts and adverse events throughout the process.The preoperative VAS scores between the two groups showed no statistically significant difference(P>0.05).The pain scores of the two groups at 7 and 14 days after surgery were improved compared with the preoperative period,and the observation group was better than that of the control group(P<0.05).The time of removing the silicone membrane,the wound healing time and the scar treatment score of the observation group were better than those of the control group(P<0.05).Compared with the preoperative swelling between the two groups,there was no statistically significant difference(P>0.05).The limb swelling subsided at 14 days after surgery was better than that of the control group(P<0.05).At the two-month follow-up after surgery,the wound healing of the two groups was good,and no obvious adverse reactions occurred,and the difference between the wound healing and TCM symptom efficacy evaluation groups was not statistically significant(P>0.05).Conclusion:Shangke Huangshui external application combined with artificial dermis has a good effect in the treatment of finger acute full-thickness skin defect wounds with automatic epi

关 键 词：急性全层皮肤缺损 伤科黄水 人工真皮 自动上皮化 

分 类 号：R641[医药卫生—外科学]