多技术联合治疗大面积烧伤疗效分析

Clinical Efficacy of Multi⁃technique Combination Therapy in Treating Extensive Burns

目的探讨分析湿润烧伤膏+Meek植皮+悬浮床治疗大面积烧伤的临床疗效。方法选取2019年2月至2022年3月中国人民解放军联勤保障部队第九九〇医院收治的62例大面积烧伤患者(烧伤总面积>50%TBSA)作为研究对象,按照不同治疗方法将其分为研究组(31例)和对照组(31例)。研究组患者采用湿润烧伤膏+Meek植皮+悬浮床治疗,对照组患者采用湿润烧伤膏+Meek植皮治疗,对比观察两组患者植皮面积、皮片成活率、烧伤创面愈合时间、供皮区创面愈合时间及治疗期间感染情况。结果研究组患者植皮面积(41.84±5.27)%TBSA与对照组患者植皮面积(43.07±6.35)%TBSA无明显差异(t=0.830,P=0.410),皮片成活率(87.83±5.34)%明显高于对照组患者皮片成活率(79.86±8.53)%(t=4.410,P<0.001),烧伤创面愈合时间(21.87±4.64)d及供皮区创面愈合时间(19.31±4.48)d均明显短于对照组患者烧伤创面愈合时间(24.59±5.57)d及供皮区创面愈合时间(21.74±4.89)d(t=2.089、2.040,P=0.041、0.046)。治疗期间,研究组患者并发创面感染8例、血液感染3例,明显少于对照组患者的并发创面感染16例、血液感染11例(χ2=4.351、5.905,P=0.037、0.015)。结论湿润烧伤膏+Meek植皮+悬浮床治疗可明显提高大面积烧伤患者植皮术后皮片成活率,缩短创面愈合时间,降低感染风险。

Objective To analyze the clinical efficacy of the combination therapy of MEBO plus Meek skin grafting plus suspension bed in treating extensive burns.Methods 62 patients with extensive burns(total burned surface area>50%TBSA),admitted into The 990th Hospital of PLA Joint Logistics Support Force between February 2019 and March 2022 were enrolled as research subjects,and divided into study group(n=31)and control group(n=31)based on different treatments they received.Patients in the study group were treated with the combination therapy of MEBO plus Meek skin grafting plus suspension bed,whereas patients in the control group with the combination therapy of MEBO plus Meek skin grafting.The skin grafting area,survival rate of skin flaps,wound healing time of burns and donor sites,and infection condition during the treatment course of patients were compared between the two groups.Results The skin grafting area of patients in the study group was(4184±527)%TBSA,which showed no significant difference as compared with the corresponding(4307±635)%TBSA in the control group(t=0830,P=0410).The survival rate of skin flaps in the study group was(8783±534)%,which was obviously higher than(7986±853)%in the control group(t=4410,P<0001).In the study group,the healing time of burn wounds was(2187±464)d,and the wound healing time of donor sites was(1931±448)d,being both shorter than the corresponding(2459±557)d and(2174±489)d in the control group(t=2089 and 2040,P=0041 and 0046).During the treatment period,8 cases developed wound infection and 3 cases developed blood infection in the study group,which were significantly less than that in the control group(χ2=4351 and 5905,P=0037 and 0015)-16 cases with wound infection and 11 cases with blood infection.Conclusion The combination therapy of MEBO plus Meek skin grafting plus suspension bed can significantly improve the survival rate of skin flaps of patients with extensive burns after skin grafting,shorten the wound healing time and reduce the infection risk.