光疗、冲击波及超声治疗烧伤的研究进展

Research Progress of Phototherapy, Shock Wave and Ultrasound in the Treatment of Burn

烧伤通常伴随着免疫和炎症反应、代谢变化,是临床上一种相对常见的危急重症。严重的烧伤会导致休克和多器官衰竭,也是患者死亡的独立风险因素。从治疗的角度来看,烧伤愈合后皮肤组织功能恢复所带来的外观和心理问题也是影响患者生活质量的主要因素。感染治疗是烧伤患者管理过程中的重要一环,但由于耐药菌的增加和局部、系统抗生素用药存在的一些局限性,探索新的抗菌治疗方案具有重要临床价值。紫外线(ultraviolet,UV)、光动力、光热等光疗(phototherapy)策略为“后抗生素时代”的抗菌治疗带来了新的曙光,并且除了抗菌作用外,还在促进伤口愈合中发挥积极作用。体外冲击波治疗(extracorporeal shock wave therapy,ESWT)、超声治疗也具有缓解烧伤局部症状、促进伤口愈合、治疗瘢痕等作用。本文综述了光疗、冲击波、超声治疗在烧伤中的应用进展,并探讨这些新兴治疗策略在烧伤治疗中的应用前景和发展挑战。

Burn is usually accompanied by immune and inflammatory reactions,metabolic changes,it is a relatively common clinical critical severe illness.Severe burns can lead to shock and multiple organ failure,which is also an independent risk factor for patient death.From the perspective of treatment,the appearance and psychological problems brought by the functional recovery of skin tissue after burn healing are also the main factors affecting the quality of life of patients.Infection treatment is an important part in the management process of burn patients.However,due to the increase of drug-resistant bacteria and some limitations of local and systemic antibiotic use,it is of important clinical value to explore new antimicrobial treatment schemes.Phototherapy strategies such as ultraviolet (UV),photodynamic,and photothermal etc bring a new dawn for the antibacterial treatment in the “post antibiotic era”.Besides the antibacterial effect,they also play an active role in promoting wound healing.Extracorporeal shock wave therapy (ESWT) and ultrasound therapy also have the effects of relieving local symptoms of burns,promoting wound healing,and treating scars.This article reviews the application progress of phototherapy,shock wave and ultrasound treatment in burn,and discusses the application prospects and development challenges of these emerging treatment strategies in burn treatment.