烧伤24h内对深Ⅱ度烧伤老年患者削痂的疗效和炎性反应分析

Curative Effect of Eschar Shaving for Elderly Patients with Deep Second-degree Burn within 24 h and Analysis of Inflammatory Reaction

目的探讨深Ⅱ度烧伤后24 h内进行削痂术在老年患者中的疗效,并进一步分析其对患者炎性指标的影响。方法整群选取2013年1月—2015年10月期间医院收治的75例老年深Ⅱ度烧伤患者作为该研究受试者,根据患者的不同削痂时间分为对照组35例、早期组40例。对照组患者为烧伤3~5 d接受削痂治疗,早期组患者烧伤24 h内完成削痂治疗。结果早期削痂治疗患者创面愈合时间、住院时间短于对照组P〈0.01,早期组一次性植皮成活率达到92.5%,并发症发生率为15.0%,均优于对照组P〈0.05;削痂治疗5 d时,早期削痂组患者在TNF-α、IL-8、IL-10水平与对照组比较,差异有统计学意义（P〈0.01）。结论烧伤24 h内进行削痂治疗明显能改善深Ⅱ度烧伤老年患者的炎性反应现状,避免了创面加深,有利于患者早期康复。

Objective To observe the curative effect of eschar shaving for elderly patients with deep second-degree burn within 24 h and further analyze the effect of it on the inflammatory indexes of patients. Methods 75 cases of elderly patients with deep second-degree burn admitted and treated in our hospital from January 2013 to October 2015 were selected as the research subjects and divided into the control group with 35 cases and the early group with 40 cases according to the different eschar shaving time, the control group received eschar shaving treatment within 3-5d after burn, and the early group finished eschar shaving treatment within 24 h after burn. Results The wound healing time and length of stay in the early group were shorter than those in the control group, P 〈0.01, the one-time survival rate of skin graft and incidence rate of complications were respectively 92.5% and 15.0% in the early group, which were better than those in the control group, P〈0.05, the differences in the TNF-α, IL-8 and IL-10 levels between the early group and the control group had obvious statistical significance, P〈0.01. Conclusion The eschar shaving treatment within 24 h after burn can obviously improve the inflammatory reaction status in elderly patients with deep second-degree burn, avoid the deepening of wounds, and it is conducive to the early rehabilitation of patients.