水动力清创系统在大面积深Ⅱ度烧伤创面清创中的应用效果  

Efficacy of hydrosurgery system applied in the debridement of patients with extensive and deep second-degree burns

作　　者：陈宏泽 刘晟[1] 陈旭林[1] Hongze Chen;Sheng Liu;Xulin Chen(Department of Burns,the First Affiliated Hosptial of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院烧伤科,合肥230022

出　　处：《中华损伤与修复杂志（电子版）》2024年第4期314-318,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的:探讨水动力清创系统(简称水刀)在大面积深Ⅱ度烧伤中的清创效果。方法:选取2019年10月至2022年10月安徽医科大学第一附属医院烧伤科收治的41例大面积深Ⅱ度烧伤患者进行回顾性队列研究,按照是否使用水刀清创分为水刀清创组(20例)和传统清创组(21例),均联合自体Meek皮片封闭创面。术后采取常规抗感染、定期换药等治疗。观察两组患者术后7 d植皮存活率、手术区愈合时间,记录并计算术后降钙素原(PCT)及C反应蛋白(CRP)降低率。数据比较采用t检验、χ^(2)检验、Mann-Whitney U检验。结果:水刀清创组的手术区植皮存活率为95.9%(87.7%,96.7%),高于传统清创组的83.3%(80.0%,87.7%),差异有统计学意义(Z=-3.748,P<0.001)。水刀清创组术后PCT降低率[(59.5±21.5)%]高于传统清创组[(26.1±32.7)%],差异有统计学意义(t=3.839,P<0.001)。水刀清创组术后CRP降低率为55.8%(32.3%,66.8%),高于传统清创组[32.3%(15.4%,37.3%)],差异有统计学意义(Z=-3.170,P=0.002)。水刀清创组手术区愈合时间为(37.1±17.3)d,短于传统清创组[(48.9±4.2)d],差异有统计学意义(t=-2.058,P=0.046)。结论:与传统清创术比较,水动力清创系统联合Meek皮片移植治疗大面积深Ⅱ度烧伤能更精准地清除坏死组织,减轻全身炎症反应,创造有利的植皮环境,提高植皮存活率,加快创面愈合。Objective To explore the effect of the hydrosurgery system in the debridement of patients with extensive and deep second-degree burns.Methods Forty-one patients with extensive and deep second-degree burns admitted to the Department of Burns,the First Affiliated Hospital of Anhui Medical University from October 2019 to October 2022 were selected for a retrospective cohort study,and were divided into a hydrosurgery system debridement group(20 cases)and a traditional debridement group(21 cases)according to whether or not hydrosurgery system was used,combined with autologous Meek micrograft technique to heal the wounds.Post-operative care included routine anti-infection and regular dressing changes.The survival rate of the implant at 7 days after surgery and the healing time of the surgical area were observed in both groups,and the postoperative procalcitonin(PCT)and C-reactive protein(CRP)reduction rates were recorded and calculated.Data were analysed using t-test,chi-square test and Mann-Whitney U test.Results The implant survival rate of the hydrosurgery system debridement group was 95.9%(87.7%,96.7%),which was significantly higher than that of the traditional debridement group[83.3%(80.0%,87.7%)],and the difference was statistically significant(Z=-3.748,P<0.001).The post-operative PCT reduction rate of the hydrosurgery system debridement group was(59.5±21.5)%,which was significantly higher than that of the traditional debridement group[(26.1±32.7)%],and the difference was statistically significant(t=3.839,P<0.001).The post-operative CRP reduction rate of the hydrosurgery system debridement group was 55.8%(32.3%,66.8%),which was significantly higher than that of the traditional debridement group[32.3%(15.4%,37.3%)],with a statistically significant difference(Z=-3.170,P=0.002).The healing time of the surgical area in the hydrosurgery system debridement group was(37.1±17.3)days,which was significantly shorter than that of the traditional debridement group(48.9±4.2)days,with a statistically significant difference

关 键 词：水动力清创系统 烧伤 Meek微型皮片 清创术 

分 类 号：R644[医药卫生—外科学]