治愈新生儿先天性皮肤缺损的换药和护理

Non-surgical method to cure the congenital defect of the newborn

目的探讨新生儿先天性皮肤缺损的治疗方法。方法2015年3月至2018年5月,滨州医学院附属医院烧伤整形外科收治11例先天性皮肤缺损新生儿,男10例,女1例。入院后评估各项生命指标及皮肤缺损情况,新生儿均于恒温保温箱内护理,个体化补液抗休克、抗感染及营养支持,加强护理,维持各器官功能。所有皮肤缺损创面用0.01%苯扎氯铵溶液清洗消毒,外用0.01%苯扎氯铵溶液湿敷包扎治疗,观察新生上皮生长情况。结果11例中1例并发败血症,3例行组织病理检查,表现为表皮过度角化伴角化不全,角质层与表皮细胞层之间有裂隙,表皮细胞呈渐进性变性坏死。经过换药治疗,11例新生儿均治愈,创面7~29 d愈合,平均21.3 d。2年后随访10例,创面愈合良好,无明显瘢痕形成,功能活动不受影响,部分区域轻度色素沉着。结论对先天性皮肤缺损新生儿,尽早维持各器官功能稳定、局部换药、加强护理,可较好地促进创面痊愈,促进皮肤结构与功能恢复。

Objective To investigate the treatment of congenital skin defects in neonates.Methods 11 newborns with congenital skin defects were admitted to our department,including 10 males and 1 female.After admission,various life indexes and skin defects were evaluated.Newborns were nursed in a constant temperature incubator,with individualized fluid replenishment,anti-shock,anti-infection and nutritional support to strengthen nursing and maintain the function of each organ.All skin defect wounds were cleaned and disinfected with 0.01%Benzalkonium chloride solution,and treated with wet dressing.The growth of new epithelium was observed.Results One of the 11 cases was complicated with septicaemia,and 3 cases were examined histopathologically.After dressing change,all the 11 newborns were cured,and the wound healed from 7 to 29 days,with an average of 21.3 days.2 years later,10 patients were followed up.The wound healed well,without obvious scar formation,functional activities were not affected,and some areas had mild pigmentation.Conclusions For newborns with congenital skin defects,maintaining the function of organs as soon as possible,changing local dressing and strengthening nursing care can promote wound healing and skin structure and function recovery.