目的

观察低频脉冲电刺激对深Ⅱ度烧伤创面愈合的影响。

方法

选择空军军医大学第一附属医院烧伤与皮肤外科2023 年3 月至12 月收治的符合纳入与排除标准的烧伤患者60 例，采用随机数字表法将患者分为观察组和对照组，每组30 例。 两组均选取患者10 cm×10 cm 深Ⅱ度创面作为受试区域。 对照组患者常规涂抹1%磺胺嘧啶银乳膏治疗，每天1 次。 观察组患者在对照组相同治疗的基础上，应用低频电子脉冲治疗仪进行低频脉冲电刺激治疗，频率50 Hz，电流强度20 mA，每天1 次，每次30 min，连续3 d。 于治疗前及治疗后第1、2、3 天采用激光多普勒血流灌注成像仪测量创面血流灌注情况。 计算治疗后第7、10、14 天的创面愈合率。 于治疗前及治疗后第3、7、14 天使用视觉模拟评分法（VAS）评估创面换药时疼痛程度。 观察并记录治疗过程中出现的不良事件。

结果

治疗前及治疗后第1 天，观察组创面血流灌注值分别为（203.53±40.99）PU、（227.53±37.79）PU，对照组创面血流灌注值分别为（213.13±32.19）PU、（223.07±31.35）PU，两组比较差异无统计学意义（t=-1.009、0.498，P=0.317、0.620）；治疗后第2、3 天，观察组创面血流灌注值分别为（254.20±32.24）PU、（277.93±26.99）PU，明显高于对照组的（234.23±27.14）PU、（245.13±23.92）PU，差异均有统计学意义（t=2.595、4.982，P＜0.05）。 治疗后第7、10、14 天，观察组创面愈合率为（16.70±4.68）%、（58.63±10.39）%、（89.03±10.72）%，均高于对照组的（12.33±4.19）%、（51.60±6.95）%、（82.10±7.12）%，差异有统计学意义（t=3.806、3.038、2.949，P＜0.01）。 治疗前，观察组与对照组的VAS 评分分别为（7.87±1.25）分、（8.03±1.19）分，差异无统计学意义（t=-0.529，P=0.599）；治疗后第3、7、14 天，观察组VAS评分分别为（4.23±0.94）分、（3.42±1.04）分、（1.57±0.89）分，均低于对照组的（5.57±1.01）分、（4.27±0.98）分、（2.20±0.93）分，差异有统计学意义（t=-5.316、-3.194、-2.692，P＜0.01）。 两组患者在治疗过程中均未发生不良事件。

结论

低频脉冲电刺激能明显改善深Ⅱ度烧伤创面早期微循环，提高创面愈合率，有效缓解疼痛症状，从而促进深Ⅱ度烧伤创面的愈合。

Objective

To explore the effect of low-frequency pulse electrical stimulation on the healing of deep partial-thickness burn wounds.

Methods

Sixty patients with deep partial-thickness burns who met the inclusion and exclusion criteria and were admitted to Department of Burns and Cutaneous Surgery， the First Affiliated Hospital of Air Force Medical University from March to December 2023 were enrolled.The patients were randomly divided into observation group and control group by random number table method，with 30 patients in each group.In both groups， 10 cm×10 cm deep partial-thickness burn wounds were selected as the test area.In the control group， patients were treated with 1% silver sulfadiazine cream on the wound surface once a day.On the basis of the same treatment in the control group， patients in the observation group were treated with low-frequency pulse electrical stimulation for 3 days using low-frequency electronic pulse therapy instrument， the frequency was 50 Hz，and the current intensity was 20 mA，once a day for 30 minutes each time.The blood flow perfusion in the wound was measured before treatment and at 1，2， and 3 days after treatment.The wound healing rate was calculated at 7， 10， and 14 days after treatment.The degree of pain during dressing change was assessed before treatment and at 3，7，and 14 days after treatment， and adverse events during treatment were recorded.

Results

Before treatment and on the first day after treatment， the wound blood perfusion values were （203.53±40.99）PU and （227.53±37.79）PU in the observation group， and（213.13±32.19）PU and （223.07±31.35）PU in the control group， there was no significant difference between the two groups （t=-1.009， 0.498； P=0.317， 0.620）.On the 2nd and 3rd day after treatment， the wound blood perfusion values of the observation group were （254.20±32.24）PU and （277.93±26.99）PU，which were significantly higher than（234.23±27.14）PU and（245.13±23.92）PU of the control group，the differences were statistically significant （t=2.595， 4.982； P＜0.05）.On the 7th，10th and 14th day after treatment，the wound healing rates of observation group were （16.70±4.68）%， （58.63±10.39）% and （89.03±10.72）%， which were higher than （12.33±4.19）%，（51.60±6.95）% and （82.10±7.12）% of the control group，the differences were statistically significant （t = 3.806， 3.038， 2.949； P ＜0.01）.Before treatment， VAS scores of the observation group and the control group were （7.87±1.25） points and （8.03±1.19） points， with no statistical significance （t=-0.529， P=0.599）.The VAS scores of the observation group were （4.23±0.94） points，（3.42±1.04） points and （1.57±0.89） points on the 3rd， 7th and 14th day after treatment， which were lower than （5.57±1.01） points， （4.27±0.98） points and （2.20±0.93） points of the control group， the differences were statistically significant （t=-5.316， -3.194， -2.692； P ＜0.01）.No adverse events occurred during treatment in both groups.

Conclusion

Low-frequency pulse electrical stimulation can significantly improve the early microcirculation of deep partial-thickness burn wounds， increase the wound healing rate， effectively relieve pain symptoms， and thereby promote the healing of deep partial-thickness burn wounds.