早期行清创切削痂植皮术对手部深度烧伤患者手部功能及美观的影响
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摘要
目的探讨早期行清创切削痂植皮术对手部深度烧伤患者手部功能及美观的影响。方法选取我院2016年1月至2018年2月收治的手部深度烧伤患者88例患者为研究对象,根据手术方法不同分为观察组与对照组各44例,对照组行保痂肉芽创面植皮术,观察组伤后早期行清创切削痂植皮术,对两组患者术后恢复情况及手功能、美观情况进行观察。结果观察组的创面愈合时间为(24.50±5.15)d,较对照组的(39.45±8.24)d明显缩短(P <0.05;观察组的植皮成活率较对照组要高,且术后相关并发症发生率较对照组要低(P <0.05。治疗后6个月,观察组的患侧手部功能优良率优于对照组(P <0.05,但两组的手部外观优良率比较,无明显的差异((P> 0.05)。结论手部深度烧伤患者行早期切削痂植皮术能提高植皮存活率,利于促进手部功能恢复,值得推广。
Objective To explore the effect of early escharectomy and skin grafting in the treatment of deep hand burns. Methods From January 2016 to February 2018,88 patients was divided into two groups according to the method of operation,44 cases in each group.The control group was treated with eschar-preserving granulation wound skin grafting,while the observation group was treated with early escharectomy and skin grafting.The recovery of two groups was compared. Results The survival rate of skin grafting,the excellent rate of hand function in the observation group were higher than control group,and the wound healing time and incidence of complications were lower than control group(P < 0.05). However,there was no significant difference in the excellent rate of hand appearance between the two groups(P > 0.05). Conclusion Early escharectomy and skin grafting can improve the success rate of skin grafting,and also promote the functional and aesthetic recovery of the hand.
Objective To explore the effect of early escharectomy and skin grafting in the treatment of deep hand burns. Methods From January 2016 to February 2018,88 patients was divided into two groups according to the method of operation,44 cases in each group.The control group was treated with eschar-preserving granulation wound skin grafting,while the observation group was treated with early escharectomy and skin grafting.The recovery of two groups was compared. Results The survival rate of skin grafting,the excellent rate of hand function in the observation group were higher than control group,and the wound healing time and incidence of complications were lower than control group(P < 0.05). However,there was no significant difference in the excellent rate of hand appearance between the two groups(P > 0.05). Conclusion Early escharectomy and skin grafting can improve the success rate of skin grafting,and also promote the functional and aesthetic recovery of the hand.
引文
[1]Nielson C B,Duethman N C,Howard J M,et al.Burns:Pathophysiology of Systemic Complications and Current Management[J].J Burn Care Res.2017,38(1):e469-e481.doi:10.1097/BCR.0000000000000355.
[2]Gardien KL,Middelkoop E,Ulrich MM,et al.Progress towards cell-based burn wound treatments[J].Regen Med.2014,9(2):201-218.doi:10.2217/rme.13.97.
[3]刘玉丽.早期整形手术治疗手部深度烧伤的临床观察[J].中国医疗美容,2016,6(7):23-25.
[4]刘嘉楠,何放,钱明元,等.丹参酮ⅡA磺酸钠对烧伤植皮创面愈合及瘢痕形成的影响[J].现代生物医学进展,2016,16(7):1306-1308.doi:10.13241/j.cnki.pmb.2016.07.024
[5]林联铎.早期整形手术治疗手部深度烧伤的临床观察[J].中国医药科学,2016,6(1):208-210,222.
[6]王配合,何泽亮,李晓东,等.手部深度烧伤患者不同手术时期行切削痂植皮术的临床疗效比较[J].疑难病杂志,2017,16(5):489-491,495.doi:10.3969/j.issn.1671-6450.2017.05.015
[7]张雪峰,宋博,林贞姬.延期自体表皮异体真皮复合植皮治疗手部深部烧伤的研究[J].中国社区医师,2015,31(25):62-63.doi:10.3969/j.issn.1007-614x.2015.25.39
[8]雷雨.深度烧伤患者不同时间切削痂植皮对术后愈合效果的影响[J].现代医药卫生,2016,32(13):2055-2056.doi:10.3969/j.issn.1009-5519.2016.13.036
[9]焦卫东,殷宏毅.早期切削痂植皮应用于手部深度烧伤中的效果[J].中国医疗美容,2015,(4):23-25.
[10]傅丹,彭小丹.57例早期切削痂植皮治疗大面积烧伤的临床疗效探究[J].吉林医学,2016,37(9):2322-2323.
[11]Zhang LJ,Cao J,Feng P,et al.Influencing factors of the quality of life in Chinese burn patients:Investigation with adapted Chinese version of the BSHS-B[J].Burns,2014,40(4):731-736.doi:10.1016/j.burns.2013.09.011.
[12]王一帆.济源市人民医院烧伤科患者病原菌分布特点及抗菌药物使用情况分析[J].中国烧伤创疡杂志,2017,29(5):305-310.doi:10.3969/j.issn.1001-0726.2017.05.001
[2]Gardien KL,Middelkoop E,Ulrich MM,et al.Progress towards cell-based burn wound treatments[J].Regen Med.2014,9(2):201-218.doi:10.2217/rme.13.97.
[3]刘玉丽.早期整形手术治疗手部深度烧伤的临床观察[J].中国医疗美容,2016,6(7):23-25.
[4]刘嘉楠,何放,钱明元,等.丹参酮ⅡA磺酸钠对烧伤植皮创面愈合及瘢痕形成的影响[J].现代生物医学进展,2016,16(7):1306-1308.doi:10.13241/j.cnki.pmb.2016.07.024
[5]林联铎.早期整形手术治疗手部深度烧伤的临床观察[J].中国医药科学,2016,6(1):208-210,222.
[6]王配合,何泽亮,李晓东,等.手部深度烧伤患者不同手术时期行切削痂植皮术的临床疗效比较[J].疑难病杂志,2017,16(5):489-491,495.doi:10.3969/j.issn.1671-6450.2017.05.015
[7]张雪峰,宋博,林贞姬.延期自体表皮异体真皮复合植皮治疗手部深部烧伤的研究[J].中国社区医师,2015,31(25):62-63.doi:10.3969/j.issn.1007-614x.2015.25.39
[8]雷雨.深度烧伤患者不同时间切削痂植皮对术后愈合效果的影响[J].现代医药卫生,2016,32(13):2055-2056.doi:10.3969/j.issn.1009-5519.2016.13.036
[9]焦卫东,殷宏毅.早期切削痂植皮应用于手部深度烧伤中的效果[J].中国医疗美容,2015,(4):23-25.
[10]傅丹,彭小丹.57例早期切削痂植皮治疗大面积烧伤的临床疗效探究[J].吉林医学,2016,37(9):2322-2323.
[11]Zhang LJ,Cao J,Feng P,et al.Influencing factors of the quality of life in Chinese burn patients:Investigation with adapted Chinese version of the BSHS-B[J].Burns,2014,40(4):731-736.doi:10.1016/j.burns.2013.09.011.
[12]王一帆.济源市人民医院烧伤科患者病原菌分布特点及抗菌药物使用情况分析[J].中国烧伤创疡杂志,2017,29(5):305-310.doi:10.3969/j.issn.1001-0726.2017.05.001