削痂术联合负压创面治疗技术治疗烧伤创面的临床效果

Clinical effect of escharectomy combined with negative pressure wound treatment in the treatment of burn wounds

目的:观察在烧伤创面治疗中应用削痂术联合负压创面治疗技术的临床效果。方法:从解放军第960医院烧伤整形科择取2020年1月至2022年4月收治的烧伤创面病例28例,对照组14例,治疗方法为单纯削痂术;研究组14例,治疗为削痂术联合负压创面治疗技术,对两组肉芽组织生长时间、创面愈合时间、换药次数、住院时间进行对比分析,测定并对比两组治疗前及治疗后7d生化指标变化,评估两组治疗前及治疗后7d的疼痛评分、生活质量评分情况,观察两组并发症情况。结果:1)研究组肉芽组织生长时间比对照组短,创面愈合时间比对照组早,换药次数比对照组少,住院时间比对照组短,差异有统计学意义(P<0.05);2)生化指标:治疗前两组对比差异无统计学意义(P>0.05),治疗后7d两组C反应蛋白、降钙素原、白细胞计数、中性粒细胞百分比均下降,研究组低于对照组,差异有统计学意义(P<0.05);3)疼痛评分:治疗前两组对比差异无统计学意义(P>0.05),治疗后7d两组评分均下降,研究组(3.09±0.44)分低于对照组(5.22±0.58)分,差异有统计学意义(P<0.05);4)生活质量评分:治疗前两组对比,差异无统计学意义(P>0.05),治疗后7d两组评分均提高,研究组(70.38±1.52)分高于对照组(62.36±1.63)分,差异有统计学意义(P<0.05);5)并发症:研究组总发生率(7.14%)低于对照组(42.86%),差异有统计学意义(P<0.05)。结论:在烧伤创面治疗中,削痂术联合负压创面治疗技术能够促进创面恢复,缩短住院时间,还可以减轻炎症反应,减轻疼痛,提高患者生活质量,避免并发症发生,具备显著临床价值。

Objective:To observe the clinical effect of escharectomy combined with negative pressure wound treatment in the treatment of burn wounds.Methods:28 cases of burn wounds admitted in the Department of burn and plastic surgery of the 960th Hospital of the PLA from November 2020 to April 2022 were selected and divided into two groups according to the digital random table method,with 14 cases in each group.The treatment method of the control group was simple escharectomy,and the treatment of the study group was escharectomy combined with negative pressure wound treatment technology.The growth time of granulation tissue,wound healing time,dressing change times and hospitalization time of the two groups were compared and analyzed,The changes of pain and biochemical indexes before and 7 days after treatment in the two groups were observed and compared.Results:1)The growth time of granulation tissue in the study group was shorter than that in the control group,the wound healing time was earlier,the dressing change times were less than that in the control group,and the hospital stay was shorter than that in the control group(P<0.05);2)Biochemical indexes:there was no significant difference between the two groups before treatment(P>0.05).7 days after treatment,the C-reactive protein,procalcitonin,leukocyte count and neutrophil percentage of the two groups decreased,and the difference in the study group was lower than that in the control group(P<0.05);3)Pain score:there was no significant difference between the two groups before treatment(P>0.05).The scores of the two groups decreased 7 days after treatment.The scores of the study group(3.09±0.44)points were lower than those of the control group(5.22±0.58)points,and the difference was statistically significant(P<0.05);4)Quality of life score:there was no significant difference between the two groups before treatment(P>0.05).The scores of the two groups increased 7 days after treatment.The score of the study group(70.38±1.52)points was higher than that of the control group(62.36±1.63)points,and the difference was statistically significant(P<0.05);5)Complications:the total incidence rate of the study group(7.14%)was lower than that of the control group(42.86%).The difference was statistically significant(P<0.05).Conclusion:In the treatment of burn wounds,escharectomy combined with negative pressure wound treatment technology can promote wound recovery,shorten hospital stay,reduce inflammatory reaction,reduce pain,improve patients'quality of life and avoid complications,which has significant clinical value.