复合皮移植术在大面积烧伤瘢痕整形患者中的实践研究
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摘要
目的分析复合皮移植术在大面积烧伤瘢痕整形患者中的应用效果。方法将2016年3月-2017年7月我院收治的81例大面积烧伤瘢痕整形患者根据随机综合序贯法分为两组,对照组(n=40)采用反复切取后躯干瘢痕皮方法,观察组(n=41)实施复合皮移植术,对比两组治疗效果差异。结果两组二次手术率、皮片成功率对比差异显著(P <0.05);观察组瘢痕颜色、瘢痕平整度、瘢痕弹性程度评分均明显低于对照组(P <0.05);两组治疗前AngⅡ(血管紧张素Ⅱ)、CD46(白细胞分化抗原46)水平对比无明显差异(P> 0.05),治疗后均明显降低,但是观察组优于同期对照组(P <0.05)。结论复合皮移植术在大面积烧伤瘢痕整形患者中的应用效果显著,具有推广性。
Objective To analyze the effect of composite skin transplantation in patients with extensive burn scar plasty. Methods 81 patients with large area burn scar plastic surgery in our hospital from March 2016 to July 2017 were divided into two groups according to random comprehensive sequential method. The control group(n=40) was treated with repeated trunk scar skin removal. The observation group(n=41) was treated with composite skin transplantation. The difference of therapeutic effect between the two groups was compared. Results There were significant differences in the second operation rate and skin graft success rate between the two groups(P < 0.05). Scar color, scar smoothness and scar elasticity in the observation group were significantly lower than those in the control group(P < 0.05). There was no significant difference in Ang II(angiotensin II) and CD46(leucocyte differentiation antigen 46) levels between the two groups before treatment.(P > 0.05), after treatment, they were significantly reduced, but the observation group was better than the control group at the same time(P < 0.05). Conclusion Compound skin transplantation is an effective method for extensive burn scar plasty.
Objective To analyze the effect of composite skin transplantation in patients with extensive burn scar plasty. Methods 81 patients with large area burn scar plastic surgery in our hospital from March 2016 to July 2017 were divided into two groups according to random comprehensive sequential method. The control group(n=40) was treated with repeated trunk scar skin removal. The observation group(n=41) was treated with composite skin transplantation. The difference of therapeutic effect between the two groups was compared. Results There were significant differences in the second operation rate and skin graft success rate between the two groups(P < 0.05). Scar color, scar smoothness and scar elasticity in the observation group were significantly lower than those in the control group(P < 0.05). There was no significant difference in Ang II(angiotensin II) and CD46(leucocyte differentiation antigen 46) levels between the two groups before treatment.(P > 0.05), after treatment, they were significantly reduced, but the observation group was better than the control group at the same time(P < 0.05). Conclusion Compound skin transplantation is an effective method for extensive burn scar plasty.
引文
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[15]刘志会,王立军,王东亮,等.脱细胞异体真皮与自体微粒复合移植术治疗大面积深度烧伤患者的疗效[J].医疗装备,2018,12(1):18-19.
[2]宋国栋,石文,高聪,等.大面积深度烧伤的早期切除与皮肤移植[J].中华损伤与修复杂志(电子版),2017,12(1):56-60.DOI:10.3877/cma.j.issn.1673-9450.2017.07.010.
[3]崔泽龙,杨小辉,首家保,等.瘢痕断层皮片联合脱细胞异体真皮治疗大面积深Ⅱ度烧伤瘢痕的疗效[J].中国修复重建外科杂志,2014(12):1502-1504.
[4]周金武,李鸿明,陈建设,等.MEEK微型皮片植皮技术在成批烧伤救治中的临床应用[J].海南医学,2015,14(4):569-571.DOI:10.3969/j.issn.1003-6350.2015.04.0205.
[5]中国整形美容协会瘢痕医学分会常务委员会专家组.中国瘢痕疙瘩临床治疗推荐指南[J].中国美容整形外科杂志,2018,18(5):11-12.DOI:10.3969/j.issn.1673-7040.2018.05.001.
[6]谢晓繁,陈冬梅,陈宇飞,等.不同植皮方式修复大面积烧伤创面的临床效果分析[J].现代生物医学进展,2016,16(4):673-676,733.DOI:10.13241/j.cnki.pmb.2016.04.017.
[7]于海霞.全厚皮移植整形外科技术在小面积深度烧伤创面修复中的价值[J].菏泽医学专科学校学报,2015,(2):21-23,39.DOI:10.3969/j.issn.1008-4118.2015.02.008.
[8]李宝,左燕妮,殷永红.烧伤后期瘢痕整形儿复合植皮手术的美容效果分析[J].西南国防医药,2017,27(12):1306-1309.DOI:10.3969/j.issn.1004-0188.2017.12.020.
[9]李卫卫,任文明,蔡景龙.烧伤后期瘢痕整形手术应用异体脱细胞真皮基质与自体薄皮片复合移植的临床研究[J].中国美容医学,2016,25(6):25-28.
[10]徐文举.复合皮移植术对大面积烧伤瘢痕整形患者血管紧张素CD46及临床疗效的影响[J].河北医学,2016,22(10):1663-1666.DOI:10.3969/j.issn.1006-6233.2016.10.032.
[11]Sajad W,Hamid R.Outcome of Split Thickness Skin Grafting and Multiple Z-Plasties in Postburn Contractures of Groin and Perineum:A 15-Year Experience[J].Plastic Surgery International,2014,14(20):1-6.DOI:10.1155/2014/358526
[12]陈玉良,肖景元.中老年原发性高血压患者血管紧张素Ⅱ、醛固酮、促肾上腺皮质激素及甲状腺激素的检测结果分析[J].湖南师范大学学报(医学版),2018,10(2):14-16.DOI:10.3969/j.issn.1673-016X.2018.02.038.
[13]孟进松,林国安,李文军,等.Meek植皮加悬浮床封闭大面积深度烧伤创面的效果观察[J].实用医药杂志,2017,34(8):693-695,698.DOI:10.14172/j.issn1671-4008.2017.08.008.
[14]王晓川.烧伤变性真皮基质可再生利用的初步研究[D].山东大学,2012.
[15]刘志会,王立军,王东亮,等.脱细胞异体真皮与自体微粒复合移植术治疗大面积深度烧伤患者的疗效[J].医疗装备,2018,12(1):18-19.