早期磨痂联合脱细胞异种真皮治疗手部深Ⅱ度烧伤的临床疗效

The clinical effect of early eschar grinding com bined with acellular xenogeneic transplantation in the treatment of deep Ⅱ degree burn of hand

目的探讨早期磨痂联合脱细胞异种真皮治疗手部深Ⅱ度烧伤的临床疗效。方法回顾性分析2013年1月~2016年12在我院烧伤科住院治疗的手部深Ⅱ度烧伤患者42例患者的临床资料,将所选病例按照治疗方法分为观察组和对照组,分别采用磨痂术和削痂术治疗,然后用脱细胞异种真皮覆盖,表皮移植术和皮肤扩张术治疗,观察手术时间、1%术中失血量及输血量、创面愈合时间;统计比较外形与功能优良率、皮片成活率以及瘢痕增生率。结果观察组手术时间、1%手术面积出血量和治愈时间均短于或小于对照组(P<0.05)。随访3个月后,观察组手部外形和功能优良率(92.0%)明显优于对照组(70.6%)(P<0.05)。半年后,观察组皮片成活率(96.0%)明显高于对照组(82.4%),瘢痕增生率(24.0%)明显低于对照组(64.7%)(P<0.05)。结论早期磨痂联合异种脱细胞真皮修复手部深Ⅱ度烧伤创面,皮片成活率好,瘢痕增生率发生率低,手部功能恢复良好,值得临床推广应用。

Objective To investigate the clinical effect of early eschar grinding combined with acellular xenogeneic transplantation in the treatment of deep II degree burn of hand. Methods 42 patients with deep II degree bum of hand in our hosital from January 2013 to December 2016 were retrospectively analyzed as the investigated subjects and they were randomly divided into observation group and control group, Respectively used eschar grinding and escharshaving, and acellular xenogeneic skin transplantation. Observed the operation time, intraoperative blood loss and blood transfusion 1% quantity, wound healing time;And compared the rate of good appearance and function, the flap survival rate and the rate of scar hyperplasia. Results The surgery time, 1% area of the bleeding and cure time of observation group wrer shorter than or less than the control group （P 〈 0.05）. After 3 months of follow-up, The hand rate of good appearance and function of observation group （92.0%） was better than control group （70.6%） （P 〈 0.05）. After six months, the flap survival rate （96.0%） of the observation group was obviously higher than that of control group （82.4%）, the rate of scar hyperplasia （24.0%）, significantly lower than the control group （64.7%） （P 〈 0.05）. Conclusion Early eschar grinding combined with acellular xenogeneic transplantation in the treatment of deep II degree burn of hand could enhance the survival rate of flap, low incidence of scar proliferation rate, recovery of hand function was good, worthy of clinical popularization and application. So it is worthy of clinical use.