痂下注射MEBO治疗深度烧伤中后期创面的临床应用研究

Clinical Application of Treating Deep Burn Wound in Midanaphase by Sub-eschar Injection of MEBO

目的:观察烧伤湿性医疗技术(MEBT/MEBO)配合痂下注射湿润烧伤膏(MEBO)治疗深度烧伤中后期创面的效果,并初步分析其机制。方法:将60例深度烧伤中后期创面患者,随机分2组,对照组完全按照MEBT/MEBO技术操作规范进行正规治疗;治疗组除完全按照MEBT/MEBO技术操作规范进行正规治疗外,每天再痂下注射MEBO 1次,直至痂皮完全脱落为止,然后继续按MEBT/MEBO正规治疗。观察痂皮脱落时间,创面愈合时间,计算创面愈合率、瘢痕率。结果:治疗组能明显缩短痂皮脱落时间和创面愈合时间,与对照组比较差异有显著性;治疗组7d、14d、21d的创面愈合率明显高于对照组,且30d时治疗组瘢痕率明显小于对照组,差异有统计学意义。结论:MEBT/MEBO配合痂下注射MEBO治疗深度烧伤中后期创面比单纯应用MEBT/ MEBO治疗创面痂皮脱落早,创面愈合快,瘢痕少,值得临床推广。

Objective： To observe the effect of treating deep burn wound in midanaphase with sub -eschar injection of MEBO and to approach the primary mechanism. Method： The 60 cases of patients with deep burn wound in midanaphase were randomly divided into two groups, i. e. test group and control group. Control group were treated with standard treatment of MEBT/MEBO while test group beside the standard treatment of MEBT/MEBO was treated with sub - eschar injection of MEBO once daily until the eschar completely shed and then continuously treated with MEBT/MEBO. The duration of eschar exfoliation and the time of wound healing were observed and recorded then the wound healing rate and the incidence rate of scarring after wound healing were calculated. Result： The duration of eschar exfloliation and the time of wound healing in test group were much shorter than that in control group ; wound healing rates of test group at the 7th 14th and 21st day were much higher than those of control test; and the incidence rate of scarring after wound healing was obviously lower at the 30th day. The difference between two groups was statistical significance. Conclusion： MEBT/ MEBO combined with sub - eschar injection of MEBO is superior to simple MEBO/MEBT therapy on deep burn wound in midanaphase in shortened duration of eschar exfoliation and the time of wound healing and lowered rate of scarring after wound healing. It is suitable to be popularized as a clinical treatment.