浸浴结合人工生物敷料和血小板胶治疗烧伤患儿后期残余创面的观察

The effect of artificial dermis and antologous platelet gel for children suffered from burn

目的观察浸浴结合人工生物敷料和血小板胶治疗烧伤后期残余创面的效果。方法将有烧伤后期残余创面的56例患儿分为实验组（28例）和对照组（28例）。实验组患儿浸浴后，用血小板胶喷洒于创面，将生物敷料覆盖于创面行半暴露疗法，用血小板胶喷湿敷料2次／d，每2至3d浸浴1次并更换敷料；对照组创面消毒后仅以单层碘伏纱布覆盖行半暴露疗法。1个疗程（10d）结束后，比较二组患儿的治愈率、有效率、创面细菌学情况及相关安全性指标。结果实验组和对照组患儿的治愈率、有效率、细菌清除率分别为64．3％、89．3％、92．3％和32．1％、67．9％、72．0％，二组上述指标比较，差异均有统计学意义（P〈0．01）。二组患儿未发生不良反应。结论浸浴结合应用新型人工生物敷料和血小板胶治疗烧伤患儿后期残余创面安全、有效，可控制创面感染、提高治愈率。

Objective To observe the residual burn wounds of children treated with artificial dermis and antologous platelet gel （APG） after immersion bath at late post-burn stage. Methods Fifty-six children with residual wounds at late post-burn stage were enrolled in the study and randomly allocated into A（n = 28,experimental） and B（n = 28, control） groups. After treatment with immersion bath, the wounds in group A were treated with semi-exposure method. The wounds were covered with artificial dermis in suitable shape and spray APG twice a day, the artificial dermis was changed every 2 day or every 3 days after immersion bath. To compare the treatment effect, the wounds in group B were only treated with a dressing of monolayer gauze wetted with povidone iodine. The clinical outcomes, bacteriological findings and associated safety parameters were compared between two groups on 10 days after treatment. Results The wound healing rate, efficacy and the bacterial clearance rate in A group were 64. 3 %, 89. 3 % and 92. 3 %, respectively, and they were significantly higher than those in B group（32. 1 %, 67. 9% and 72. 0% ,respectively, P〈0.01）. No adverse side-effect was noted in either group. Conclusions Application of artificial dermis and APG after immersion bath is safe and effective for the elimination of residual wounds at late post-burn stage, which is beneficial to control wound infection and promote the wound healing.