点状自体皮与辐照异种皮改良复合移植的临床应用研究

Punctate clinical application of modified composite graft to autolo- gous skin with irradiated xenogeneic skin

目的探讨点状自体皮与辐照异种皮改良复合移植的I临床效果。方法对人选的80例大面积烧伤患者，采用分层随机分组的方法分为治疗组及对照组，每组40例，治疗组在常规治疗的基础上，人院后第3—5天行切削痂，点状自体皮移植后辐照异种皮覆盖；对照组40例，其中20例行点状自体皮移植网眼油纱覆盖后加压包扎，20例行点状自体皮移植新鲜猪皮覆盖。观察比较两组患者点状自体皮成活情况、辐照异种皮排斥、创面愈合时间及愈合率、换药工作量、患者疼痛度及1年后患者瘢痕及功能恢复情况。结果治疗组术后1周换药见辐照异种皮贴服完整，2周辐照异种皮呈干痂状。4—5周干痂逐渐分离，创面愈合。创面愈合时间治疗组（29．5±5）d较对照组（39．6±4）d明显缩短（P〈0．01）。创面愈合率治疗组（86．8±3．8）％较对照组（34．2±2．1）％明显提高（P〈0．01）。创面感染率降低30％，换药的劳动强度降低70％，减轻患者疼痛。1年后患者瘢痕平整其弹性及功能良好。结论点状自体皮与辐照异种皮改良复合移植提高了皮肤移植的成活率，有利于创面愈合，对治疗大面积烧伤创面修复可行有效。

Objective Clinical effects of dot from body skin irradiated xenogeneic skin improved composite graft. Methods Selected 80 patients with severe burn patients randomized after admission on the basis of conven- tional treatment, 3-5 days line Crust treatment group transplanted autologous point-like skin irradiation pigskin cov- erage. Results Treatment of patients in group one week dressing see irradiated pigskin Tiefu full two weeks the pig- skin was dry scab- like. Wound healing treatment group （ 29 -＋ 5 ） days （ P 〈 0.01 ） was significantly shorter than the control group（ 39 ＋4） days. Wound healing rate of treatment is significantly higher than the control group （P 〈 0.01 ）. Wound infection rate reduced greatly reduce labor intensity and dressing, and reduce pain . 1 year after scar formation in patients with good flexibility and functionality. Conclusions Punctate since improved composite body skin irradiated xenogeneic skin transplantation can improve skin graft survival rate, promote wound healing, treat- ment of a large area of the burn wound repair is feasible and effective.