烧伤湿润暴露疗法治疗深Ⅱ度创面病理学观察

Pathomorphological Observation on Deep Second Degree Burn Wound Treated with Moist Exspital Burn Therapy

目的：探讨烧伤湿润暴露疗法（ MEBT）治疗深Ⅱ烧伤创面的病理变化及其修复的再生属性。方法：分别于治疗后 1， 3， 5， 7， 10， 15， 20天及愈合后取创面组织标本，常规光镜、电镜制样，进行普通光镜和透射电镜观察。结果：治疗后 1天～ 3天，烧伤组织变性、坏死，继之发生液化、剥脱，至第 10天达高潮。之后残存的皮肤附件皮增生移行和肉芽组织增生渐成为其主要变化；与之相应的创面内炎性细胞也出现一系列活动。结论： MEBT治疗深Ⅱ度烧伤创面的病理演变过程分三期：①变性坏死期；②液化反应期；③再生修复期。但各期之间病变存在交叉重叠现象。其创面修复属完全性生理性再生。

Objective: To explore the pathological changes and regenerative properties of deep second degree burn wounds treated with Moist Exposed Burn Therapy (MEBT). Method: Tissue specimens were obtained from the wounds on day 1,3,5,7,10,15 and 20 post treatment and observed under optical and electron microscopes. Results: On day 1 to 3, denaturation and necrosis of the burn tissue started and then liquefaction and exfoliation, reaching its peak on day 10 post burn. Later on, survival skin appendage epithelium began to proliferate and migrate, and granulation tissue began to proliferate, at the same time, a series of actions took place in inflammatory cells in the wounds. Conclusion: Pathological changes of the deep second degree burn wounds treated with MEBT took place in three stages: 1. Denaturation and necrosis stage, 2. Liquefaction stage and 3. Restoration stage. These stages may overlap. The wound healing was completely physiological regeneration.