自体水疱微粒皮移植对重度烧伤患者的疗效及对愈合和增生情况的影响(1)
[摘要]目的：探讨自体水疱微粒皮移植对重度烧伤患者的治疗效果，及对愈合情况和增生恢复情况的影响。方法：选取2016年3月-2017年10月在笔者医院接受治疗的重度烧伤患者为研究对象，根据其植皮方式的不同分为对照组(采用自体皮和异体皮混合植皮术)和观察组(采用自体水疱微粒皮移植术)。观察两组患者的治疗效果，比较两组患者皮片存活率、换药次数、皮片融合时间、瘢痕指数和手术前后炎症因子水平的差异。结果：观察组治疗有效率为100.00%，明显高于对照组的75.00%，差异有统计学意义(P<0.05)。观察组皮片存活率高于对照组，术后换药次数、皮片融合时间和瘢痕指数均低于对照组，差异有统计学意义(P<0.05)。观察组患者治疗后的IL-6、hs-CRP和TNF-α水平均低于对照组，差异有统计学意义(P<0.05)。结论：自体水疱微粒皮移植对重度烧伤患者有较好的治疗效果，可明显提高患者的皮片成活率和瘢痕增生情况，具有良好的临床应用价值。
[关键词]重度烧伤；自体皮移植；水疱微粒皮；炎症因子
, 百拇医药
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)11-0110-03
Abstract： Objective To investigate the effect of autologous blister skin grafting on the treatment of severe burns， and its influence on the healing and the recovery of hyperplasia. Methods The severe burn patients treated in our hospital from March 2016 to October 2017 were selected as the research objects. According to the different skin grafting methods， they were divided into control group (autologous skin and allogeneic skin mixed skin grafting) and observation group (using autologous blister skin grafting). The therapeutic effect of the two groups was observed. The survival rate of skin graft， times of dressing change， skin fusion time， scar index and the difference of inflammatory factors before and after operation were compared between the two groups. Results The effective rate of the observation group was 100%， significantly higher than that of the control group (75.00%)， the difference was statistically significant(P<0.05). The survival rate of skin graft in the observation group was higher than that in the control group， and the number of dressing changes， skin fusion time and scar index in the observation group were lower than those in the control group(P<0.05).The levels of IL-6， hs-CRP and TNF-α in the observation group were lower than those in the control group after treatment(P<0.05). Conclusion Autologous blister skin grafting has a good therapeutic effect on severe burn patients， can significantly improve the survival rate of skin graft and scar hyperplasia， and has good clinical value.
, 百拇医药
Key words： severe burns； autologous skin grafting； Blister microskin； inflammatory factors
重度燒伤是烧伤科临床常见的危急重症，具有救治难度大、病情进展迅速等特点。重度烧伤后创面的恢复和功能的改善是评价烧伤科治疗效果的重点，需要接受皮片移植。但由于自体皮源紧缺、异体皮源难求，临床上常采用自体皮和异体皮混合植皮术治疗。但异体皮价格昂贵、保存条件要求高、易发生感染、排斥反应，并牵涉到宗教、伦理等问题，影响其应用[1]。自体水疱微粒皮移植是采用薄纱扩张自体皮片，实现1：4、1：6、1：9的扩大植皮，可提升自体皮肤移植速度，缩短手术时间，较好地解决了自体皮源紧缺的问题，又避免了异体皮的诸多缺陷[2]。本研究探讨了自体水疱微粒皮移植对重度烧伤患者的治疗效果，及对愈合情况和增生恢复情况的影响，现报道如下。
1 资料和方法
, 百拇医药
1.1 临床资料：选取2016年3月-2017年10月在笔者医院接受治疗的重度烧伤患者为研究对象。纳入标准：①年龄≥18周岁；②烧伤深度为符合重度烧伤的标准[3]；③无明显休克征象，无重症感染者。排除标准：①合并器官功能衰竭者；②不愿参与本项研究者。根据纳入排除标准共纳入研究对象40例，其中对照组20例，男14例，女6例；年龄28～63岁，平均(52.98±5.82)岁；深Ⅱ度烧伤12例，Ⅲ度烧伤8例；烧伤面积为(45.68±2.34)%。观察组20例，男16例，女4例；年龄29～64岁，平均(53.05±6.11)岁；深Ⅱ度烧伤15例，Ⅲ度烧伤5例；烧伤面积为(45.68±2.34)%。两组患者均未发生吸入伤，两组患者年龄、性别、烧伤深度和面积等一般资料无明显差别，具有可比性。本项研究经医院伦理委员会评审通过，且所有患者均知情同意。, 百拇医药(雄婉玲 高桂云)
[关键词]重度烧伤；自体皮移植；水疱微粒皮；炎症因子
, 百拇医药
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455(2018)11-0110-03
Abstract： Objective To investigate the effect of autologous blister skin grafting on the treatment of severe burns， and its influence on the healing and the recovery of hyperplasia. Methods The severe burn patients treated in our hospital from March 2016 to October 2017 were selected as the research objects. According to the different skin grafting methods， they were divided into control group (autologous skin and allogeneic skin mixed skin grafting) and observation group (using autologous blister skin grafting). The therapeutic effect of the two groups was observed. The survival rate of skin graft， times of dressing change， skin fusion time， scar index and the difference of inflammatory factors before and after operation were compared between the two groups. Results The effective rate of the observation group was 100%， significantly higher than that of the control group (75.00%)， the difference was statistically significant(P<0.05). The survival rate of skin graft in the observation group was higher than that in the control group， and the number of dressing changes， skin fusion time and scar index in the observation group were lower than those in the control group(P<0.05).The levels of IL-6， hs-CRP and TNF-α in the observation group were lower than those in the control group after treatment(P<0.05). Conclusion Autologous blister skin grafting has a good therapeutic effect on severe burn patients， can significantly improve the survival rate of skin graft and scar hyperplasia， and has good clinical value.
, 百拇医药
Key words： severe burns； autologous skin grafting； Blister microskin； inflammatory factors
重度燒伤是烧伤科临床常见的危急重症，具有救治难度大、病情进展迅速等特点。重度烧伤后创面的恢复和功能的改善是评价烧伤科治疗效果的重点，需要接受皮片移植。但由于自体皮源紧缺、异体皮源难求，临床上常采用自体皮和异体皮混合植皮术治疗。但异体皮价格昂贵、保存条件要求高、易发生感染、排斥反应，并牵涉到宗教、伦理等问题，影响其应用[1]。自体水疱微粒皮移植是采用薄纱扩张自体皮片，实现1：4、1：6、1：9的扩大植皮，可提升自体皮肤移植速度，缩短手术时间，较好地解决了自体皮源紧缺的问题，又避免了异体皮的诸多缺陷[2]。本研究探讨了自体水疱微粒皮移植对重度烧伤患者的治疗效果，及对愈合情况和增生恢复情况的影响，现报道如下。
1 资料和方法
, 百拇医药
1.1 临床资料：选取2016年3月-2017年10月在笔者医院接受治疗的重度烧伤患者为研究对象。纳入标准：①年龄≥18周岁；②烧伤深度为符合重度烧伤的标准[3]；③无明显休克征象，无重症感染者。排除标准：①合并器官功能衰竭者；②不愿参与本项研究者。根据纳入排除标准共纳入研究对象40例，其中对照组20例，男14例，女6例；年龄28～63岁，平均(52.98±5.82)岁；深Ⅱ度烧伤12例，Ⅲ度烧伤8例；烧伤面积为(45.68±2.34)%。观察组20例，男16例，女4例；年龄29～64岁，平均(53.05±6.11)岁；深Ⅱ度烧伤15例，Ⅲ度烧伤5例；烧伤面积为(45.68±2.34)%。两组患者均未发生吸入伤，两组患者年龄、性别、烧伤深度和面积等一般资料无明显差别，具有可比性。本项研究经医院伦理委员会评审通过，且所有患者均知情同意。, 百拇医药(雄婉玲 高桂云)
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