磺胺嘧啶银对大面积烧伤复合皮移植术后创面愈合、细胞因子及瘢痕形成的影响  

Effect of Silver Sulfadiazine on Wound Healing,Cytokines and Scar Formation in Patients with Extensive Burn after Composite Skin Grafting

作　　者：刘驰星 双峰[1] 李浩[1] 蔡晓敏[1] LIU Chixing;SHUANG Feng;LI Hao;CAI Xiaomin(Department of Burn and Plastic Surgery,the 908th Hospital of the PLA Joint Logistic Support Force,Nanchang 330001,Jiangxi,China)

机构地区：[1]中国人民解放军联勤保障部队第908医院烧伤整形科,江西南昌330001

出　　处：《中国美容医学》2024年第8期27-30,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨磺胺嘧啶银对大面积烧伤患者复合皮移植术后创面愈合、细胞因子及瘢痕的影响。方法:选取2020年1月-2022年12月笔者医院收治的80例大面积烧伤患者,按照随机数字表法分为对照组与观察组,每组40例。两组均行复合皮移植术,对照组术后创面行常规消毒治疗,观察组术后创面予磺胺嘧啶银软膏治疗,比较两组的创面愈合率、创面愈合时间、细胞因子[血管紧张素Ⅱ(AngⅡ)、CD46、白细胞介素-6(IL-6)、γ-干扰素]水平、温哥华瘢痕量表(VSS)评分及并发症。结果:观察组创面愈合时间明显短于对照组(P<0.05);术后7、14、21 d,观察组创面愈合率均明显高于对照组(P<0.05)。术后21 d,观察组血清AngⅡ、CD46、IL-6水平明显低于对照组(P<0.05),血清γ-干扰素水平明显高于对照组(P<0.05)。术后12周,观察组VSS评分明显低于对照组(P<0.05)。观察组并发症发生率明显低于对照组(P<0.05)。结论:大面积烧伤患者复合皮移植术后创面外涂磺胺嘧啶银,可提高创面愈合率,缩短创面愈合时间,改善细胞因子水平,减少瘢痕形成,且并发症少,值得在临床应用。Objective To investigate the effect of silver sulfadiazine on wound healing,cytokines and scar in patients with extensive burn after composite skin grafting.Methods 80 patients with extensive burn who were selected in the author's hospital from January 2020 to December 2022,the patients were divided into control group and observation group according to the random number table method,with 40 cases in each group.The composite skin grafting was carried out in two groups,the control group was treated with conventional wound disinfectionv after operation,and the observation group was treated with silver sulfadiazine ointment after operation.The wound healing rate,wound healing time,level of cytokines[serum AngiotensinⅡ(AngⅡ),CD46,Interleukin-6(IL-6),γ-interferon],vancouver scar scale(VSS)score and complications were compared between two groups.Results The wound healing time in observation group was significantly shorter than that in control group(P<0.05).At 7,14,21 days after operation,the wound healing rate in observation group was significantly higher than that in control group(P<0.05).At 21 days after operation,the serum levels of AngⅡ,CD46 and IL-6 in observation group were significantly lower than those in control group(P<0.05),and the serum levels ofγ-interferon were significantly higher than that in control group(P<0.05).The VSS scores were significantly lower than those in control group(P<0.05).At 12 weeks after operation,the complication rate in observation group was significantly lower than that in control group(P<0.05).Conclusion The use of silver sulfadiazine after composite skin transplantation for large area burn patients can improve the wound healing rate,shorten the wound healing time,improve cytokine levels,reduce scar formation,and have fewer complications,which is worthy of clinical application.

关 键 词：大面积烧伤 复合皮移植术 磺胺嘧啶银 创面 细胞因子 瘢痕 

分 类 号：R644[医药卫生—外科学]