注射用血凝酶喷洒对大面积烧伤自体植皮供皮区疗效观察

Effect of Reptilase Spraying upon the Donor Areas for Auto-skin-grafting in Patients with Extensive Burn

目的随机观察大面积深度烧伤患者供皮区局部应用注射用血凝酶的止血效果。方法选择30例将双侧大腿作为供皮区的大面积深度烧伤患者,设计同一患者的双侧大腿取皮面积、深度相同,一侧取皮后的创面局部喷洒注射用血凝酶溶液(治疗组),另一侧创面喷洒相同剂量(体积)0.9%氯化钠注射液作为对照(对照组),分别观察两组供皮区创面内层肉眼可见沾血纱布平均层数并对照。结果术后第4天,治疗组创面内层肉眼可见沾血纱布平均层数(13.00±3.75),明显少于对照组(16.00±3.12)(P<0.05),两组术后至创面愈合期间供皮局部反应差异无显著性,用药前及用药后3 d内凝血酶原时间(PT)、部分凝血活酶时间(APTT)值差异无显著性,均未见明显的不良反应。结论注射用血凝酶用于大面积深度烧伤患者局部止血效果肯定、安全方便。

Objective To survey the hemostatic effect of reptilase spraying upon the donor areas for auto-skin-grafting in patients with deep extensive burn. Methods Thirty patients with deep extensive burn were chosen as subjects of the study, their unaffected skin of the bilateral thighs serving as donor areas of auto- skin-grafting. Skin grafts of the same size and thickness were taken from the bilateral unaffected thighs of the same patients for auto-skin-grafting. After the blood from the wounds had been swabbed away, the wound surfaces of the left thigh and right thigh were sprayed with reptilase and 0.9% sodium chloride solution, respectively, followed by pressure bandaging covering layers of gauze. The hemostatic effect of the drugs was assessed by the average number of the layers of gauze stained with blood that was visible to the naked eye. Results In the wounds of the left thigh that had been treated with reptilase spraying, the average number of the layers of gauze stained with blood that was visible to the naked eye was （ 13.00 ± 3.75 ）, which was significantly smaller than that in the wounds of the right thigh that had been treated with normal saline spraying （ 16.00 ± 3. 12 ） （ P 〈 0.05 ） 4 days after the operation. No adverse reactions were encountered in the treatment. Conclusion Reptilase spraying upon the donor areas in patients with extensive burn scheduled for auto-skin-grafting was shown to be an effective measure for local hemostasis.