多功能清创仪治疗烧伤创面的临床疗效及对创面组织液炎症因子影响分析  

Clinical Efficacy of Multifunctional Debridement Instrument in the Treatment of Burn Wounds and Its Effect on Inflammatory Factors of Wound Tissue Fluid Analysis

作　　者：张美光[1] 李天尹 阳纯兵[1] 肖勇[1] ZHANG Meiguang;LI Tianyin;YANG Chunbing;XIAO Yong(Department of Burns and Plastic Wound Yepair Surgery,Yuebei People's Hospital,Shaoguan,Guangdong Province,512026 China)

机构地区：[1]粤北人民医院烧伤整形创面修复外科,广东韶关512026

出　　处：《世界复合医学》2023年第10期28-32,共5页World Journal of Complex Medicine

基　　金：韶关市卫生健康科研计划项目(Y21130)。

摘　　要：目的探讨多功能清创仪治疗烧伤创面的临床疗效及对创面组织液炎症因子的影响。方法选取2020年1月—2022年6月粤北人民医院收治30例深度烧伤患者为对象,按随机数表法分为超声清创治疗组(11例)、负压封闭引流(vacuum sealing drainage,VSD)清创组(10例)、削痂清创组(9例)。对比治疗前后3组细菌清除率,白细胞介素-1(interleukin-1,IL-1)、白细胞介素-6(interleukin-6,IL-6)、基质金属蛋白酶-3(matrix metalloproteinase-3,MMP-3)mRNA表达水平;随访半年后,比较3组瘢痕发生率,温哥华瘢痕量表(Vancouver Scar Scales,VSS)评分、换药次数、创面愈合时间。结果治疗后,与超声清创治疗组相比,削痂清创组大肠杆菌清除率为(27.16±3.01)%、金黄色葡萄球菌清除率为(42.51±2.30)%,VSD治疗组大肠杆菌清除率为(45.36±3.62)%、金黄色葡萄球菌清除率为(59.36±3.61)%,差异有统计学意义(F=36.541、48.546,P=0.001)。治疗后,与超声清创治疗组相比,削痂清创组的IL-1水平为(28.63±7.96)pg/mL、IL-6水平为(46.91±8.36)pg/mL、MMP-3 mRNA表达水平为(0.96±0.10),VSD治疗组的IL-1水平为(24.62±6.95)pg/mL、IL-6水平为(40.01±8.19)pg/mL、MMP-3 mRNA表达水平为(0.58±0.06),差异有统计学意义(F=4.962、12.638、43.958,P=0.001)。与超声清创治疗组相比,削痂清创组、VSD治疗组换药疼痛评分较高,换药次数较多,创面愈合时间较长,差异有统计学意义(P<0.05)。随访半年后,超声清创治疗组瘢痕发生率、VSS评分均低于削痂清创组、VSD治疗组,差异有统计学意义(P<0.05)。结论在烧伤患者创面修复中,多功能清创仪可控制创面感染、炎症反应,减轻换药疼痛度,促进创面愈合,减少瘢痕发生。Objective To explore the clinical efficacy of multifunctional debridement instrument in the treatment of burn wounds and its effect on inflammatory factors of wound tissue fluid.Methods A total of 30 patients with deep burn treated in North Guangdong People's Hospital from January 2020 to June 2022 were selected and divided into the ultrasonic debridement treatment group(11 cases),the vacuum sealing drainage(VSD)group(10 cases)and the scab debridement group(9 cases)according to the random number table method.Bacterial clearance rates of interleukin-1(IL-1),interleukin-6(IL-6),matrix metalloproteinase-3(MMP-3 mRNA expression level)were compared before and after treatment in 3 groups.After half a year of follow-up,the incidence of scar,Vancouver Scar Score(VSS),dressing change times and wound healing time of the 3 groups were compared.Results After treatment,the Escherichia coli and staphylococcus aureus clearance rates were(27.16±3.01)%and(42.51±2.30)%in the escherichia coli and staphylococcus aureus clearance rates were(45.36±3.62)%and(59.36±3.61)%in the VSD treatment group,compared with those in the ultrasonic debrication treatment group,the difference was statistically significant(F=36.541,48.546,P=0.001).After treatment,compared with ultrasonic debridement treatment group,IL-1 level was(28.63±7.96)pg/mL,IL-6 level was(46.91±8.36)pg/mL,and MMP-3 mRNA expression level was(0.96±0.10)in the scab debridement group.In the VSD treatment group,IL-1 level was(24.62±6.95)pg/mL,IL-6 level was(40.01±8.19)pg/mL,and MMP-3 mRNA expression level was(0.58±0.06),the differences were statistically significant(F=4.962,12.638,43.958,P=0.001).Compared with the ultrasonic debridement treatment group,the pain score of dressing change in the scab debridement group and the VSD treatment group was higher,the dressing change times was more,and the wound healing time was longer,the difference was statistically significant(P<0.05).After half a year of follow-up,the incidence of scar and VSS score in ultrasonic debridement treatme

关 键 词：烧伤创面 多功能清创仪 炎症因子 临床疗效 

分 类 号：R4[医药卫生—临床医学]