不同植皮方式修复大面积烧伤创面的临床疗效分析

Clinical effect analysis of different skin grafting methods in repairing large area burn wounds

目的研究对比不同植皮方式修复大面积烧伤创面的临床疗效。方法 120例大面积烧伤患者,随机分为Meek皮组、微粒皮组和邮票皮组,各40例。分别按照Meek皮、微粒皮、邮票皮三种方式进行修复。术后随访2年,测定记录患者一期愈合率、康复情况、成活率、死亡率、愈合时间和1%烧伤面积(1%TBSA)治疗费用,比较组间差异。结果邮票皮组成活率最高,愈合时间最短,一期愈合率高,1%TBSA治疗费用最低,但康复效果差;微粒皮组愈合时间较短,但成活率低,1%TBSA治疗费用最高,一期愈合率低,康复效果差,死亡率高;Meek皮组成活率较高,康复效果好,死亡率低,但愈合时间长。三组间成活率、愈合时间、1%TBSA治疗费用、一期愈合率、死亡率、康复率比较,差异具有统计学意义(P<0.05)。结论不同植皮方式用于大面积烧伤创面修复的临床效果各不相同,各有优缺点,临床上应该根据患者的自身情况选择不同的植皮方式。

Objective To research and compare clinical effect of different skin grafting methods in repairing large area burn wounds. Methods A total of 120 patients with large area burn wounds were randomly divided into Meek skin group, microskin group and stamps skin group, with 40 cases in each group, and retrospectively repaired by Meek skin, microskin and stamps skin. Record and comparison were made on healing rate in first stage, rehabilitation condition, survive rate, mortality, healing time and 1% total body surface area（1%TBSA） treatment cost of three groups in 2 year postoperation follow-up. Results Stamps skin group had highest survival rate, shortest healing time, high healing rate in first stage and lowest 1%TBSA treatment cost, but worst rehabilitation effects. Microskin group had shorter healing time, but low survival rate, highest 1%TBSA treatment cost, low healing rate in first stage, bad rehabilitation effects and high mortality. Meek skin group had high survival rate, good rehabilitation effects and low mortality, but long healing time. Three groups had statistically significant difference in survival rate, healing time, 1%TBSA treatment cost, healing rate in first stage, mortality, and rehabilitation rate（P〈0.05）. Conclusion Different skin grafting methods show various clinical effects in repairing large area burn wounds, each method had advantages and disadvantages. Different skin grafting methods should be used according to self-condition of patients.