巴克无菌敷贴治疗深Ⅱ度烧伤及愈合后瘢痕的效果评价

Clinical study on the prevention of deep second-degree burn scar with traditional Chinese medicine dressing

目的评价巴克无菌敷贴治疗深Ⅱ度烧伤及愈合后瘢痕的效果。方法按照纳入及排除标准,采用随机数字表法将济宁医学院附属医院2016年9月至2019年9月入院治疗的深Ⅱ度烧伤患者随机分为试验组和对照组。试验组使用巴克无菌敷贴换药,对照组使用磺胺嘧啶银乳膏换药,每2~3天换药1次。比较两组患者创面愈合时间、换药次数、换药时疼痛评分及二次创伤评分、创面愈合后1、3、6个月的温哥华瘢痕量表(VSS)评分,以及出院时和创面愈合6个月时患者满意度的差异。根据资料的数据类型,以x±s、M(Q_(1),Q_(3))或频数(百分数)表示,分别以t检验、Mann-Whitney U检验或χ^(2)检验进行分析。结果试验组和对照组各纳入132例烧伤患者。试验组男115例,女17例,年龄(34.5±11.1)岁,烧伤面积占(15.87±8.66)%;对照组男107例,女25例,年龄(32.4±14.1)岁,烧伤面积占(16.31±7.06)%。试验组愈合时间明显短于对照组[(17.65±5.87)d vs.(23.06±8.78)d,P<0.01],创面愈合后1、3、6个月的VSS评分亦均小于对照组[5(3,5)vs.6(5,7)分,4(3,5)分vs.6(4,7)分,4(3,5)分vs.5(4,6)分,P值均<0.01]。此外,试验组的换药次数、换药时疼痛评分、二次创伤评分均小于对照组(P值均<0.01);患者出院时及创面愈合6个月时的满意度评分和治疗满意百分比均高于对照组(P值均<0.01)。结论巴克无菌敷贴可显著缩短深Ⅱ度烧伤创面的愈合时间,减轻瘢痕增生,改善换药时的舒适度,提高患者满意度。

Objective To evaluate the effect of Barker aseptic application on the treatment of deep second-degree burns and scars after healing.Methods According to the inclusion and exclusion criteria,deep second-degree patients admitted to the Affiliated Hospital of Jining Medical College from September 2016 to September 2019 were randomly divided into treatment and control groups using a random number table method.Barker aseptic application was used for the treatment group,and silver sulfadiazine cream was used for the control group.Patients in two groups were changed dressing every 2 to 3 days.Wound healing time,times of dressing change,pain score during the dressing change,secondary trauma score,and Vancouver Scar Scale(VSS)score at 1,3,and 6 months after wound healing were compared between the two groups.Differences in patient satisfaction at discharge and 6 months after wound healing were also compared at follow-up.According to the result type of the data,it is expressed as Mean x±SD,M(Q_(1),Q_(3))or frequency(percentage),and it is described as the t-test,Mann-Whitney U test,or chi-square test.Results One hundred and thirty-two burn patients were enrolled in each treatment and control group.There were 115 males and 17 females in the treated group,aged(34.5±11.1)years,with the burn surface area accounting for(15.87±8.66)% of the total body surface area(TBSA).107 males and 25 females were in the control group,aged(32.4±14.1)years,with burn surface area accounting for(16.31±7.06)% TBSA.The healing time of the treated group was significantly shorter than that of the control group[(17.65±5.87)d vs.(23.06±8.78)d,P<0.01],and the VSS scores at 1,3,and 6 months after wound healing were also lower than that of the control group[5(3,5)vs.6(5,7),4(3,5)vs.6(4,7),4(3,5)vs.5(4,6),P<0.01].In addition,the number of dressing changes,pain scores during dressing changes,and secondary trauma scores in the treatment group were lower than in the control group(all P values<0.01).The satisfaction score and percentage of satisfaction with treatment were higher in the patients at discharge and 6 months of wound healing than in the control group(all P values<0.01).Conclusions Barker aseptic application can significantly shorten the healing time of deep second-degree burn wounds,reduce scar hyperplasia,improve comfort during dressing changes,and improve patient satisfaction.