冷却疗法治疗烧伤的临床与实验研究

Clinical and experiment study of cooling therapy on burned wound

研究局部冷却疗法对人体Ⅱ度烧伤创面的作用，并通过实验观察其对大鼠皮肤组织活力的影响。方法在临界温度以下持续１５～３２分钟冷却治疗（Ⅱ度烧伤创面），观察疼痛减轻程度和消失时间及愈合快慢。观察冷却疗法对烫伤大鼠皮肤组织活力的影响。结果冷却治疗创面比对照组早２天愈合；深Ⅱ度烫伤大鼠非冷却治疗组皮肤组织活力明显下降，同时Ｓｃｈｉｆ碱的含量增高。早期冷却治疗（即刻，１０～２０分钟）皮肤的活力可以保存６５％～８５％，迟延冷却治疗（３０分钟以后）皮肤组织活力下降明显，Ｓｃｈｉｆ碱含量也相应上升。结论早期冷却疗法可以有效的保存细胞活力，降低脂质过氧化损伤，促进创面愈合。

Objective To observe the subjective benefit of pain relief by cooling therapy when wound temperature drops to below 28℃ (threshold for pain). Method 22 patients with partial thickness burns who received cooling therapy showed 2 days early healing as compared with untreated burn wounds. As a first aid measure, prolonged cooling therapy (up to 30′) was recommended. In experimental study, the protective effects with cooling therapy were observed in wistar rats with deep second degree burns. Results Lower epithelial cell activity and higher schiff alkaline values were seen in the wound skin tissue in the non cooling therapy than in early cooling therapy groups and healthy controls. The groups with early cooling therapy (at once, 10′, 20′ after scalded injuries) the epithelial cell activity maintained at 83%, 80%, 65%. Conclusion The results suggest that cooling therapy can protect the epithelial cell activity to some extent after scalded injuries which may be associated with inhibition of lipid peroxide.