早期削痂对深Ⅱ度烧伤创面愈合的临床研究(1)
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【摘要】 目的 探讨深Ⅱ度烧伤创面伤后24 h内削痂的临床疗效。 方法将30例有削痂手术指征并在伤后24 h内行削痂术的深Ⅱ度烧伤患者设为实验组，并另选30例削痂条件相似而且按常规在伤后4~6d行削痂手术设为对照组。比较两组在休克期补液量、并发症发生率、尿量及创面愈合时间。结果 两组患者在休克期的补液量比较差异无统计学意义(P>0.05)，实验组在休克期的尿量显著多于对照组(P<0.05或0.01)，并发症发生率显著低于对照组(P<0.05)，同时创面愈合时间较对照组明显缩短(P<0.01)。结论深Ⅱ度烧伤创面于伤后24 h内削痂是安全的，并能缩短创面愈合时间，减轻患者的经济负担。
【关键词】 深Ⅱ度烧伤；削痂术；创面愈合
文章编号：1003-1383(2010)06-0671-02 中图分类号：R 664文献标识码：A
doi:10.3969/j.issn.1003-1383.2010.06.008
Clinical study of early tangential excision for deep Ⅱ burn wound healing
HUANG Zhiqun，LU Gang,GU Shixing,TANG Qiang
(Department of Burns Plastic Surgery,the Affiliated Hospital of Youjiang Medical
College for Nationalities,Guangxi,Baise 533000,China)
【Abstract】 Objective To study the clinical effect of tangential excision for wound healing within 24h after deep Ⅱ burn.
Methods 30 patients with surgical indications and under going tangential excision with 24h after deep Ⅱ degree burn were chosen as the treatment group.30 cases of similar conditions for tangential excision and under going operation during 4 to 6 days after injury were chosen as the control group.Their fluid volume in shock stage,incidence rate of complication,urine volume and wound healing time was compared.
Results There was no significant difference of the fluid volume in shock stage between two groups(P>0.05); the urine volume of treatment group was larger than control group in shock stage,while the complication rate was significantly lower, and the wound healing time was shorter comparing with control group(P<0.01).
Conclusion The tangential excision for wound healing within 24h after deep Ⅱ burn wounds is safe and can shorten healing time and reducing the economic burden of patients.
【Key words】 the deep Ⅱ degree burn injury；tangential excision;wound healing
深度烧伤创面坏死组织的存在是导致创面进行性加深及体内一系列病理生理性改变的根源,应用手术方法去除深度烧伤创面坏死组织，并有效覆盖创面是救治深度烧伤的主要手段[1]。临床实施削痂手术一般在伤后4~6 d,此时会出现创面加深的现象，因此通过调整削痂的手术时间、方法达到改善或防止深Ⅱ度烧伤创面进行性加深，是当前烧伤外科界急需解决的难点和热点[2]。笔者通过对深Ⅱ度烧伤患者的创面于伤后24 h内行削痂术，观察其安全性及创面愈合的疗效，探讨早期削痂的可行性。
资料与方法
1.一般资料 选择2007年1月至2010年2月在我科住院的深Ⅱ度烧伤患者60例，患者伤后创面未作特别处理，均为伤后24 h内入院，且有削痂手术指征。随机分为两组，实验组30例，男24例，女6例，平均年龄为(30±6)岁 ......
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