蜡疗对手部烧伤患者植皮术后恢复情况的影响  

Effects of wax therapy on hand function recovery after skin grafting in patients with hand burns

作　　者：焦爱丽 王伟阁[1] 崔承铭 JIAO Aili;WANG Weige;CUI Chengming(Department of Burn and Plastic Surgery,the First People′s Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院烧伤整形外科,商丘476000

出　　处：《华夏医学》2025年第2期91-96,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ202101613)。

摘　　要：目的观察蜡疗对手部烧伤患者植皮术后手功能恢复情况影响。方法选取118例手部烧伤患者作为研究对象,按照随机数字表法分为常规组和蜡疗组,每组59例。两组患者均接受Meek植皮术治疗,常规组术后实施常规体外冲击波治疗,蜡疗组在常规组的治疗基础上联合实施蜡疗。比较两组患者的炎症指标,创面生长情况,创面疼痛、瘢痕改善情况及手功能恢复情况。结果在不同治疗方案下,蜡疗组的C反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞计数(WBC)水平均低于常规组,差异具有统计学意义(P<0.05);蜡疗组的表皮生长因子(EGF)、血小板衍生生长因子(PDGF)、转化生长因子β1(TGF-β1)、碱性成纤维生长因子(bFGF)水平均高于常规组(P<0.05);蜡疗组的治疗2周、4周后的视觉模拟疼痛量表(VAS)、温哥华瘢痕量表(VSS)评分均低于常规组(P<0.05);蜡疗组随访结束时的掌指关节(MCP)、近端指间关节(PIP)及远端指间关节(DIP)的耐受角度,手部握力均大于常规组(P<0.05)。结论蜡疗能减轻手部烧伤患者植皮术后炎症反应,促进患者创面愈合,减轻创面疼痛或瘢痕,并可改善患者手部功能。Objective To observe the impact of wax therapy on the recovery of hand function in patients with hand burns following skin grafting surgery.Methods 118 patients with hand burns were selected as research subjects and randomly divided into the conventional group and wax therapy group using a random number table method,with 59 patients in each group.Both groups were received Meek skin grafting treatment.The conventional group were underwent conventional extracorporeal shock wave therapy postoperatively,while the wax therapy group were received combined wax therapy in addition to conventional treatment.The inflammatory indicators,wound healing,wound pain,scar improvement,and hand function recovery were compared between the two groups.Results Under different treatment plans,the levels of C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),and white blood cell count(WBC)in the wax therapy group were lower than those in the conventional group,with statistically significant differences(P<0.05).The levels of epidermal growth factor(EGF),platelet-derived growth factor(PDGF),transforming growth factorβ1(TGF-β1),and basic fibroblast growth factor(bFGF)in the wax therapy group were higher than those in the conventional group(P<0.05).The visual analog scale(VAS)scores for pain in the wax therapy group were lower than those in the conventional group after 2 and 4 weeks of treatment,and the Vancouver Scar Scale(VSS)scores were also lower(P<0.05).At the end of follow-up,the tolerance angles of the metacarpophalangeal joint(MCP),proximal interphalangeal joint(PIP),and distal interphalangeal joint(DIP),as well as hand grip strength,were all greater in the wax therapy group compared to the conventional group(P<0.05).Conclusion Wax therapy can alleviate the inflammatory response in patients with hand burns after skin grafting,promote wound healing,reduce wound pain and scars,and improve hand function.

关 键 词：手部烧伤 植皮术 蜡疗 手部功能 

分 类 号：R62[医药卫生—整形外科]