负压封闭引流治疗特殊部位烧伤植皮的临床效果及植皮成活率分析

Clinical Effect and Survival Rate Analysis of Skin Grafting in the Treatment of Special Site Burns with Vacuum Sealing Drainage

目的 探讨特殊部位烧伤植皮选择负压封闭引流治疗的临床价值。方法 随机选取2018年4月—2022年4月临沂市中心医院收治的70例特殊部位烧伤患者为研究对象,依据不同治疗方法分为对照组(35例,采用游离植皮治疗)和观察组(35例,采取游离植皮联合负压封闭引流治疗)。比较两组患者治疗效果、炎症因子水平、术后换药次数、疼痛介质水平、并发症发生率、预后效果。结果 观察组术后3 d植皮成活率、术后6 d创面愈合率高于对照组,差异有统计学意义(P均<0.05)。术后2周,观察组白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α、C反应蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。观察组术后换药次数少于对照组,差异有统计学意义(P<0.05)。术后1周,观察组5-羟色胺、神经肽Y、前列腺素F2α水平均低于对照组,差异有统计学意义(P均<0.05)。观察组住院时间、创面愈合时间短于对照组,差异有统计学意义(P均<0.05)。观察组并发症发生率为2.86%(1/35),低于对照组的22.86%(8/35),差异有统计学意义(χ^(2)=4.590,P<0.05)。结论 特殊部位烧伤患者植皮治疗采用负压封闭引流方案可减轻机体疼痛程度,降低炎症因子水平,降低并发症发生率,缩短创面愈合及住院时间,值得临床借鉴。

Objective To investigate the clinical value of negative pressure sealing drainage in the treatment of special sites burn skin grafting.Methods 70 cases of burn patients with special sites treated in Linyi Central Hospital from April 2018 to April 2022 were randomly selected as the study objects,and were divided into control group(35 cases,treating with free skin grafting)and observation group(35 cases,treating with free skin grafting combined with negative pressure sealing drainage according to different treatment methods).The therapeutic effect,inflammatory factor levels,postoperative dressing changes,pain mediators,incidence of complications and prognosis were compared between the two groups.Results The survival rate of skin grafting at 3 days after surgery and the wound healing rate at 6 days after surgery in the observation group were higher than those in the control group,and the differences were statistically significant(both P<0.05).2 weeks after surgery,the levels of interleukin-6,interleukin-8,tumor necrosis factor-αand C-reactive protein in observation group were lower than those in control group,the differences were statistically significant(all P<0.05).The number of dressing changes in the observation group was less than that in the control group,and the difference was statistically significant(P<0.05).One week after operation,the levels of 5-hydroxytryptamine, neuropeptide Y and prostaglandin F2α in observation group were lower than those in control group, and the differences were statistically significant (all P<0.05). The hospitalization time and wound healing time of observation group were shorter than those of control group, and the differences were statistically significant (both P<0.05). The in cidence of complications in the observation group was 2.86% (1/35) lower than that in the control group 22.86% (8/ 35), and the difference was statistically significant (χ^(2)=4.590, P<0.05). Conclusion Vacuum sealing drainage for skin grafting in special sites burn patients can reduce the pain degree, reduce the level of inflammatory factors, reduce the incidence of complications, shorten the wound healing and hospital stay, which is worthy of clinical reference.