58例氢氟酸烧伤创面早期切痂植皮治疗效果观察

Effect of early eschar excision plus skin grafting on hydrofluoric acid burns

目的观察氢氟酸烧伤创面早期行切痂植皮治疗效果。方法 58例氢氟酸致深Ⅱ~Ⅲ度烧伤患者随机分为2组,行切痂手术植皮治疗的30例为观察组,给予保痂肉芽创面植皮治疗的28例为对照组,观察2组临床疗效及并发症发生率。结果观察组创面愈合时间为（27.6±10.2）d,植皮成活率（96.2±4.3）%,表皮破溃率（3.8±1.7）%,瘢痕积分为（3.6±0.7）分;对照组分别为（40.2±12.0）d、（84.3±5.1）%、（12.3±4.7）%、（6.2±1.1）分,2组比较差异均有统计学意义（P〈0.05）;观察组术后第1、2、3天最高体温（（37.94±0.56）、（37.79±0.49）、（37.65±0.45）℃）均低于对照组（（38.45±0.63）、（38.17±0.51）、（38.06±0.48）℃）（P〈0.05）;观察组并发症发生率为20.00%,无死亡病例,对照组并发症发生率为75.00%,病死率为21.43%,2组比较差异均有统计学意义（P〈0.05）。结论氢氟酸烧伤创面早期行切痂植皮疗效确切,术后并发症发生率低。

Objective To investigate the effect of early removal of eschar plus skin grafting on hydronuoric acid burns.Methods Fifty-eight patients withⅡtoⅢ degree burns by hydrofluoric acid were randomly divided into observation group（n=30）treated with eschar excision plus skin grafting,and control group（n=28）treated with eschar reserving granulation plus skin grafting.The therapeutic effect was observed and compared between two groups.Results The average wound healing time was（27.6±10.2）days,skin graft survival rate was（96.2±4.3）%,skin ulceration rate was（3.8±1.7）%,and scar score was 3.6±0.7in observation group,and were（40.2±12）days,（84.3±5.1）%,（12.3±4.7）% and 6.2±1.1in control group,showing significant differences between two groups（P〈0.05）.The highest body temperatures on the lst,2nd and 3rd day after operation were（37.94±0.56）,（37.79±0.49）and（37.65±0.45）℃in observation group,significantly lower than those in control group（（38.45±0.63）,（38.17±0.51）,（38.06±0.48）℃）（P〈0.05）.The incidence of complications and fatality was 20.00% and 0in observation group,significantly lower than those in control group（75.00%,21.42%）（P〈0.05）.Conclusion Early eschar excision plus skin grafting is effective for hydrofluoric acid burns,with low incidence of complications.