早期应用脱细胞异体真皮治疗深度烧伤的临床研究

Clinical research of early allogeneic acellular dermal matrix on deep burn wound

目的使用脱细胞异体真皮和自体皮片对深度烧伤的患者进行皮肤移植修复治疗，并对其临床治疗效果进行探讨。方法选择2011年12月～2013年4月高州市人民医院烧伤外科诊治的18例深度烧伤患者为研究对象，将其随机分为观察组和对照组，每组各9例。观察组患者给予脱细胞异体真皮和自体皮片皮肤移植修复治疗，对照组患者仅给予自体皮片移植修复治疗。对比分析两组患者创面成活率、术后1、6月创面情况（水疱和破溃）、关节活动、温哥华评分。结果观察组自体皮片一次成活率为88．9％，显著性高于对照组（66．7％），差异有统计学意义（x。=4．192，P=O．01）；术后1个月，观察组的创面水疱和破溃情况、关节活动、温哥华评分与对照组比较，差异无统计学意义（P〉0．05）；术后6个月，观察组的创面水疱和破溃情况、关节活动、温哥华评分则优于对照组，差异有统计学意义（P〈0．05）。结论脱细胞异体真皮和自体皮片联合移植术能有效的对深度烧伤进行皮移植治疗，并能减少患处瘢痕的增生以及改善创面的外观和功能。

Objective To use allogeneic acellular dermal matrix and with the transplantation of autogenous thin thick- ness skin to repair deep burn wound, and investigate the clinical effect. Methods 18 patients with deep burn wound from December 2011 to April 2013 in the People＇s Hospital of Gaozhou City were selected and randomly divided into two groups, 9 cases in each group. Patients in observation group were treated by allogeneic acellular dermal matrix and with the transplantation of autogenous thin thickness skin; patients in control group were treated by transplantation of autogenous thin thickness skin. The survival rate of wound, wound condition （blister and burst）, joint motion, Vancouver score in 1 and 6 months after treatment of two groups were compared. Results The survival rate of observation group was 88.9%, which was significantly higher than that of control group （66.7%）, the difference was statistically significant （X2=4.192, P=0.01）. After 1 month, there was no significant difference in the wound condition （blister and burst）, joint motion and Vancouver score of observation group and control group （P 〉 0.05）; after 6 month, the wound condition, joint motion and Vancouver score of observation group were obviously better than those of control group, the differences were statistically significant （P 〈 0.05）. Conclusion The composite skin grafts with allogeneic acellular dermal matrix and thin thickness skin were using to repair the skin defects of large area deep burn and scar resection, the woUnd healing well, satisfied with the aopearance of the skin function.