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中华损伤与修复杂志(电子版) ›› 2017, Vol. 12 ›› Issue (02) : 128 -131. doi: 10.3877/cma.j.issn.1673-9450.2017.02.011

所属专题: 文献

论著

休克期磨痂对小儿深Ⅱ度烧伤创面愈合及瘢痕形成的影响
肖虎,1, 王一兵1, 薛文君1, 霍然1, 王德昌1   
  1. 1. 250021 济南,山东大学附属省立医院烧伤整形科
  • 收稿日期:2016-12-26 出版日期:2017-04-01
  • 通信作者: 肖虎
  • 基金资助:
    山东省卫生厅医药卫生科技发展计划(2014WS0354); 国家自然科学基金面上项目(81272099); 山东省卫生厅医药卫生科技发展计划青年基金(2009QZ023); 山东省科技厅优秀中青年科学家科研奖励基金(BS2009YY043)

Study on dermabrasion in the shock phase of children extensive deep partial thickness burns

Hu Xiao,1, Yibing Wang1, Wenjun Xue1, Ran Huo1, Dechang Wang1   

  1. 1. Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
  • Received:2016-12-26 Published:2017-04-01
  • Corresponding author: Hu Xiao
  • About author:
    Corresponding author: Xiao Hu, Email:
引用本文:

肖虎, 王一兵, 薛文君, 霍然, 王德昌. 休克期磨痂对小儿深Ⅱ度烧伤创面愈合及瘢痕形成的影响[J/OL]. 中华损伤与修复杂志(电子版), 2017, 12(02): 128-131.

Hu Xiao, Yibing Wang, Wenjun Xue, Ran Huo, Dechang Wang. Study on dermabrasion in the shock phase of children extensive deep partial thickness burns[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2017, 12(02): 128-131.

目的

研究小儿深Ⅱ度烧伤创面休克期磨痂的临床效果。

方法

选取2010年1月至2015年1月山东大学附属省立医院烧伤科收治的深Ⅱ度烧伤小儿80例,根据治疗方法不同将患儿分为随机磨痂组和对照组,每组40例。磨痂组于伤后48 h内在全身麻醉下实施磨痂手术。对照组创面予磺胺嘧啶银外涂包扎,隔日换药。利用100 MHz高分辨率B型超声观察磨痂后患儿创面血运情况,观察记录两组患儿住院期间的换药次数、创面愈合时间、残余创面植皮率,以温哥华烧伤瘢痕评定量表作为标准评估瘢痕增生情况,相关指标比较采用t检验及χ2检验。

结果

与对照组相比,磨痂组创面血流信号显著增强。磨痂组创面愈合时间(15.4±3.5)d短于对照组(21.6±4.7) d,差异具有统计学意义(t=12.735,P<0.05)。两组换药次数比较,磨痂组术后换药次数[(5.6±2.2)次]少于对照组[(10.5±3.8)次],差异有统计学意义(t=14.435,P<0.05)。两组残余创面植皮率比较,磨痂组(15%)低于对照组(35%),差异有统计学意义(χ2=4.363,P<0.05)。磨痂组温哥华烧伤瘢痕评分[(5.0±1.6)分]低于对照组[(9.7±2.2)分],差异有统计学意义(t=13.235,P<0.05)。

结论

休克期磨痂能明显改善小儿深Ⅱ度烧伤创面血运,促进创面愈合,显著降低患儿再植皮手术发生率,减少换药次数,减轻瘢痕增生,值得临床推广应用。

Objective

To analyze the clinical effect of dermabrasion in the shock phase of children extensive deep partial thickness burns.

Methods

Eighty cases of deep burn hospitalized children were selected in department of burns and plastic surgery, Shandong Provincial Hospital Affiliated to Shandong University from January 2010 to January 2015. All the burn children were divided into the dermabrasion group and the control group, according to different treatments, 40 cases each group.In the dermabrasion group, the patients received eschar grinding operation in 48 hours after injury. In the control group, the patients were treated with silver sulfadiazine. The burn wound blood flow signal of the two groups were observed by 100 MHz B-Ultrasound at shock stage. The wound healing time, the rate of changing wound dressing, the rate of skin grafting operation, scar hyperplasia were assessed by the vancouver of burn scar rating scale.In vancouver of burn scar rating scale for assessment of standard scar hyperplasia and the wound healing quality index were observed. Relevant indicators were analysised by t test and Chi-square.

Results

Compared with the control group, the burn wound blood flow signal of the dermabrasion group significantly enhanced. The wound healing time was shorter[(15.4±3.5) d] than the control group[(21.6±4.7) d], the difference was statistically sinificant (t=12.735, P<0.05). The switching frequency of the dermabrasion group [(5.6±2.2) times] was less than the control group [(10.5±3.8) times], the difference was statistically sinificant (t=14.435, P<0.05). The rate of changing wound dressing of the dermabrasion group (15%)was lower than the control group(35%), the difference was statistically sinificant(χ2=4.363, P<0.05). The vancouver score of the dermabrasion group [(5.0±1.6) scores] was less than the control group [(9.7±2.2) scores], the difference was statistically sinificant(t=13.235, P<0.05).

Conclusion

The treatment of dermabrasion at the shock stage has the advantages of shortening wound healing time and light scar.

表1 两组烧伤患儿一般资料比较
图1 B型超声观察两组烧伤患儿创面真皮层血流信号,红色和蓝色分别表示正向和逆向的血流
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