切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2022, Vol. 17 ›› Issue (02) : 141 -144. doi: 10.3877/cma.j.issn.1673-9450.2022.02.009

论著

自体邮票植皮术联合冲洗治疗在烧伤患者中的疗效观察
郑刚1, 谢志2, 黄涛1, 谷才之2,()   
  1. 1. 830000 乌鲁木齐,新疆医科大学第八附属医院烧伤科
    2. 830000 乌鲁木齐,新疆军区总医院药剂科
  • 收稿日期:2022-01-17 出版日期:2022-04-01
  • 通信作者: 谷才之

Effect of stamp skin grafting combined with irrigation therapy in burn patients

Gang Zheng1, Zhi Xie2, Tao Huang1, Caizhi Gu2,()   

  1. 1. Department of Burns, Eight Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
    2. Department of Pharmacy, General Hospital of Xinjiang Military Region, Urumqi 830000, China
  • Received:2022-01-17 Published:2022-04-01
  • Corresponding author: Caizhi Gu
引用本文:

郑刚, 谢志, 黄涛, 谷才之. 自体邮票植皮术联合冲洗治疗在烧伤患者中的疗效观察[J]. 中华损伤与修复杂志(电子版), 2022, 17(02): 141-144.

Gang Zheng, Zhi Xie, Tao Huang, Caizhi Gu. Effect of stamp skin grafting combined with irrigation therapy in burn patients[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2022, 17(02): 141-144.

目的

分析自体邮票植皮术联合冲洗治疗在深度烧伤患者中的治疗效果。

方法

选取新疆医科大学第八附属医院2015年1月至2019年1月收治的68例大面积烧伤患者,随机数字表法分为2组:对照组与观察组,每组34例。对照组Ⅰ期行清创削痂手术、自体邮票植皮术治疗;观察组在此基础上每日联合进行创面冲洗治疗持续至自体邮票植皮术手术前夕,后行邮票植皮术,观察2组手术时间,Ⅰ期创面愈合率、康复率,以及创面分泌物细菌培养阳性率,术后3、7、15 d植皮成活率以及创面愈合时间,评估患者治疗前、治疗后3个月以及治疗后6个月视觉模拟评分法(VAS)评分。数据比较采用t检验。

结果

观察组手术时间[(70.31±7.69) min]略长于对照组[(66.52±8.41) min],差异无统计学意义(t=1.939, P>0.05),观察组Ⅰ期创面愈合率、康复率[(77.34±7.05)%、(74.27±5.84)%]明显高于对照组[(65.61±6.92)%、(63.41±3.35)% ],且创面分泌物细菌培养阳性率[(21.19±4.42)%]低于对照组[(64.36±11.25)%],差异均有统计学意义(t= 6.924、9.406、20.826, P<0.05)。术后3、7、15 d,观察组植皮存活率[(34.11±5.26)%、(59.31±4.72)%、(3.19±1.42)%]均高于对照组[(28.64±11.45)%、(51.74±5.68)%、(64.71±8.25)%],差异均有统计学意义(t=2.531、5.977、3.717,P<0.05),且观察组创面愈合时间[(3.19±1.42) d]短于对照组[(5.36±2.25) d],差异有统计学意义(t=4.756, P<0.05)。治疗前2组VAS评分差异无统计学意义P>0.05),治疗后3个月、6个月,观察组VAS评分[(5.41±0.34)、(3.35±1.09)分]分别低于对照组[(6.15±1.28)、(4.37±1.24)分],差异均有统计学意义(t=3.258、3.603,P<0.05)。

结论

大面积烧伤患者应用邮票植皮术联合进行创面冲洗治疗可有效改善手术指标,提高植皮存活率,对疼痛缓解也有一定帮助。

Objective

To analyze the effect of stamp skin transplantation combined with irrigation therapy in the treatment of deep burn patients.

Methods

A total of 68 patients with large-area burns were enrolled in Eight Affiliated Hospital of Xinjiang Medical University from January 2015 to January 2019. They were divided into two groups: the control group and the observation group, with each group had 34 cases, according to the random number table. The control group was treated with debridement and escharectomy(stage I), and stamp skin grafting, the observation group was combined with irrigation therapy every day until the eve of stamp skin grafting and then stamp skin grafting on this basis. The operation time, wound healing rate(stage I), recovery rate, positive rate of bacterial culture of wound secretion, survival rate of skin graft and wound healing time at 3, 7 and 15 days after operation were observed, visual analogue scale (VAS) scores were assessed before treatment, 3 months after treatment and 6 months after treatment. Data was processed with t test.

Results

The operation time of the observation group[(70.31±7.69) min] was slightly longer than that of the control group[(66.52±8.41) min], there was no statistically significant difference(t=1.939, P>0.05); The wound healing rate and recovery rate in the observation group[(77.34±7.05)%, (74.27±5.84)%] were significantly higher than those[(65.61±6.92)%, (63.41±3.35)% ] in the control group, and the positive rate of bacterial culture in wound secretion[(21.19±4.42)%] was significantly lower than that in the control group[(64.36±11.25)%], the differences were statistically significant(t= 6.924, 9.406, 20.826; P<0.05). At 3, 7, 15 days after operation, the survival rates of skin graft in the observation group [(34.11±5.26)%, (59.31±4.72)%, (3.19±1.42)%]were higher those in the control group[(28.64±11.45)%, (51.74±5.68)%, (64.71±8.25)%], the differences were statistically significant(t=2.531, 5.977, 3.717; P<0.05), moreover the wound healing time of the observation group[(3.19±1.42) d] was shorter than that of the control group[(5.36±2.25) d], the difference was statistically significant(t=4.756, P<0.05). There was no significant difference in the VAS score between the two groups before treatment(P>0.05). At 3 months and 6 months after treatment, the VAS scores of the observation group[(5.41±0.34) points, (3.35±1.09) points] were lower than those of the control group[(6.15±1.28) points, (4.37±1.24) points], and the differences were statistically significant (t=3.258, 3.603; P<0.05).

Conclusion

The application of stamp skin grafting combined with wound irrigation therapy in patients with large-area burns can effectively improve surgical indicators, improve the survival rate of skin grafting, and help to relieve pain.

表1 2组大面积烧伤患者手术相关指标比较(±s)
表2 2组大面积烧伤患者植皮存活率及创面愈合时间比较(±s)
表3 2组大面积烧伤患者VAS评分比较(分,±s)
[1]
刘丹,张雪峰,冯国友,等. 扩创植皮联合封闭负压引流技术在大面积烧伤患者感染难愈创面治疗的效果[J]. 中华医院感染学杂志2017, 6(9): 2088-2091.
[2]
Vaghardoost R, Momeni M, Kazemikhoo N, et al. Effect of low-level laser therapy on the healing process of donor site in patients with grade 3 burn ulcer after skin graft surgery (a randomized clinical trial)[J]. Lasers Med Sci, 2018, 33(3): 603-607.
[3]
徐晓婷,朱玉玲,王芳,等. 有创动脉血压监测在"8.2"昆山爆炸特大面积烧伤伤员救治中的应用[J]. 实用临床医药杂志2017, 21(8): 139-141.
[4]
向光俊,杨洪政,马云飞,等. 封闭负压引流技术在大面积烧伤后期感染难愈创面治疗中的应用[J]. 临床与病理杂志2015, 35(8): 1493-1497.
[5]
Hayashi M, Muramatsu H, Nakano M, et al. Experience of using cultured epithelial autografts for the extensive burn wounds in eight patients[J]. Ann Plast Surg, 2014, 73(1): 25-29.
[6]
孙济宇,罗晓庆,王晓波,等. 负压封闭引流术联合冲洗液持续冲洗在深Ⅱ度烧伤中应用的效果评价[J]. 中国实用护理杂志2014, 30(13): 48-50.
[1] 陈宏兴, 张立军, 张勇, 李虎, 周驰, 凡一诺. 膝骨关节炎关节镜清理术后中药外用疗效的Meta分析[J]. 中华关节外科杂志(电子版), 2023, 17(05): 663-672.
[2] 姚咏明. 如何精准评估烧伤脓毒症患者免疫状态[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 552-552.
[3] 王成, 张慧君, 覃凤均, 陈辉. 网状植皮与ReCell表皮细胞种植在深Ⅱ度烧伤治疗中的疗效对比[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 498-502.
[4] 涂家金, 廖武强, 刘金晶, 涂志鹏, 毛远桂. 严重烧伤患者鲍曼不动杆菌血流感染的危险因素及预后分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 491-497.
[5] 中华医学会烧伤外科学分会小儿烧伤学组. 儿童烧伤早期休克液体复苏专家共识(2023版)[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 371-376.
[6] 蔡柔妹, 曾洁梅, 黄伟丽, 谢文敏, 刘燕丹, 吴漫君, 蔡楚燕. 利用QC小组干预降低经烧伤创面股静脉置管导管相关性感染发生率的临床观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 399-404.
[7] 何雪锋, 赵世新, 李珮珊, 刘恒登, 谢举临. 卡奴卡叶提取物通过增强真皮成纤维细胞功能促进大鼠创面修复的效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 405-412.
[8] 赵雅玫, 谢斌, 陈艳, 吴健. 抗生素骨水泥联合负压封闭引流对糖尿病足溃疡临床疗效的荟萃分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 427-433.
[9] 汪国建, 谭雨龙, 龙爽, 吕晓凡, 赵娜, 冉新泽, 王军平, 王涛. 高温高湿环境暴露对重度放创复合伤小鼠损伤恢复的影响[J]. 中华损伤与修复杂志(电子版), 2023, 18(04): 285-292.
[10] 程飚. 浓缩血小板制品在创面修复中应用与思考[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 276-276.
[11] 茹天峰, 戴浩楠, 袁林, 吴坤平, 谢卫国. 对肌肉超声在严重烧伤患者肌肉性能评估中应用的效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 197-203.
[12] 杨姣, 王玲, 古兰, 安慎通, 胡大海, 韩军涛. 对艾司氯胺酮在烧伤后瘢痕手术患儿静脉穿刺中的应用效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 210-216.
[13] 李峰, 黎君友, 冯书堂, 李国平, 杨洁蓉. 对GGTA1/β4GalNT2双基因敲除近交系五指山小型猪皮进行异种移植的效果观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 241-248.
[14] 陈旭渊, 罗仕云, 李文忠, 李毅. 腺源性肛瘘经手术治疗后创面愈合困难的危险因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 82-85.
[15] 王燕, 郭蕊, 王淑杰. 老年烧伤气管切开患者死亡风险诊断模型构建及对策分析[J]. 中华诊断学电子杂志, 2023, 11(04): 249-253.
阅读次数
全文


摘要