削痂清创与水刀清创治疗中面积深Ⅱ度烧伤创面的临床效果比较  

Comparison of Clinical Effects between Scab Removal and Debridement and Water Knife Debridement Treatment for Moderate Area DeepⅡDegree Burn Wounds

作　　者：刘礼平[1] 邓涛 朱鹏[1] LIU Liping;DENG Tao;ZHU Peng(Department of Burn and Plastic Surgery,Ji’an Central Hospital,Ji’an 343000,China)

机构地区：[1]吉安市中心人民医院烧伤整形外科,江西吉安343000 [2]吉安市中心人民医院疼痛科,江西吉安343000

出　　处：《中国医学创新》2024年第15期131-135,共5页Medical Innovation of China

摘　　要：目的:比较中面积深Ⅱ度烧伤患者应用削痂清创与水刀清创治疗的临床效果。方法:选取2021年1月—2023年3月吉安市中心人民医院收治的中面积深Ⅱ度烧伤患者,共82例,按照随机数字表法分成水刀清创组(41例)与削痂清创组(41例)。水刀清创组采用水刀清创治疗,削痂清创组采用削痂清创治疗。比较两组临床指标、预后情况、创面愈合质量、炎症因子及疼痛介质。结果:水刀清创组每1%面积清创时间、创面愈合时间、住院时间均较削痂清创组短,创面细菌菌落数更少,差异均有统计学意义(P<0.05)。相较削痂清创组,水刀清创组二次清创率更低,差异有统计学意义(P<0.05)。相较削痂清创组,水刀清创组改良温哥华瘢痕评估量表(mVSS)评分均更低,差异均有统计学意义(P<0.05)。治疗后,两组降钙素原(PCT)、C反应蛋白(CRP)水平均较治疗前下降,相较削痂清创组,水刀清创组均更低,差异均有统计学意义(P<0.05)。治疗后,两组5-羟色胺(5-HT)、神经肽Y(NPY)水平均较治疗前下降,相较削痂清创组,水刀清创组均更低,差异均有统计学意义(P<0.05)。结论:与削痂清创比较,中面积深Ⅱ度烧伤患者应用水刀治疗的效果更好,能够改善临床指标及预后情况,促进创面良好愈合,调节炎症因子、疼痛介质水平。Objective:To compare the clinical effects of scab removal debridement and water knife debridement treatment on patients with medium area deepⅡdegree burns.Method:A total of 82 patients with moderate area deepⅡdegree burns who were admitted in Ji’an Central Hospital from January 2021 to March 2023 were selected and divided into the water knife debridement group(41 cases)and the scab removal debridement group(41 cases)by random number table method.The water knife debridement group was treated with water knife debridement,while the scab removal debridement group was treated with scab removal debridement.Clinical indicators,prognosis,wound healing quality,inflammatory factors and pain mediators were compared in both groups.Result:In comparision of the scab removal debridement group,debridement time per 1%area,wound healing time,and hospital stay time in the water knife debridement group were shorter,bacterial colonies on the wound surface was fewer,the differences were statistically significant(P<0.05).In comparision of the scab removal debridement group,the secondary debridement rate of the water knife debridement group was lower,the difference was statistically significant(P<0.05).In comparision of the scab removal debridement group,the modifier vancouver scar scale(mVSS)scores in the water knife debridement group were lower,the differences were statistically significant(P<0.05).After treatment,the procalcitonin(PCT)and C reactive protein(CRP)levels in both groups were decreased compared to those before treatment,and in comparision of the scab removal debridement group,those in the water knife debridement group were lower,the differences were statistically significant(P<0.05).After treatment,the 5-hydroxy tryptamine(5-HT)and neuropeptide Y(NPY)levels in both groups were decreased compared to those before treatment,and in comparision of the scab removal debridement group,those in the water knife debridement group were lower,the differences were statistically significant(P<0.05).Conclusion:Compared with scab re

关 键 词：中面积深Ⅱ度烧伤创面 削痂清创 水刀 

分 类 号：R644[医药卫生—外科学]