早期磨痂联合脱细胞异种皮覆盖术治疗大面积深Ⅱ度烧伤

发布时间：2018-05-11 09:06

本文选题：大面积烧伤 + 深Ⅱ度　；参考：《安徽医科大学》2016年硕士论文

【摘要】：一.研究目的探讨早期磨痂联合脱细胞异种皮覆盖术在大面积(大于50%TBSA)深Ⅱ度烧伤中的临床疗效。二.研究方法回顾性分析安徽医科大学解放军174医院2009年9月~2013年9月收治入院的大面积深Ⅱ度烧伤60例患者,早期补液抗休克后行早期磨痂术+异种皮覆盖治疗(A组)20例,早期磨痂术+纳米银医用抗菌敷料覆盖治疗(B组)20例和保守换药(C组)20例,观察术后抗生素应用时间、发热持续时间、血小板下降时间、并发症发生率、疼痛程度、创面愈合时间、住院时间、3个月及12个月瘢痕评分等指标,瘢痕评分采用m VSS-TBSA。三.结果早期磨痂术联合脱细胞异种皮覆盖组术后抗生素应用时间、发热持续时间、血小板下降时间较B组和C组均缩短,差异有统计学意义(P均0.01);脓毒症、MODS等并发症发生率较B组和C组为低(P0.05);换药次数较B组、C组减少。与B组和C组比较,A组患者疼痛程度较轻、愈合时间及住院时间缩短,3个月及12个月平均温哥华瘢痕评分—体表面积均降低,瘢痕增生轻、关节活动度好。四.结论早期磨痂术联合脱细胞异种皮覆盖术能缩短大面积深Ⅱ度烧伤创面愈合时间,降低并发症的发生,改善愈后功能。
[Abstract]:I. Objective to investigate the clinical effect of early scab abrasion combined with acellular xenoclast covering on large area (> 50 TBSAs) deep second degree burn. II. Methods A retrospective analysis of 60 patients with large area deep second degree burn admitted to PLA 174 Hospital of Anhui Medical University from September 2009 to September 2013 was carried out. 20 patients in group A were treated with early scab skin covering after fluid resuscitation. Early scab grinding with nano-silver medical antibacterial dressing was performed in 20 patients in group B and 20 patients in group C with conservative change of medicine. The time of antibiotic application, duration of fever, time of platelet decline, incidence of complications and degree of pain were observed. Wound healing time, hospitalization time, scar score at 3 and 12 months, and scar score were measured by mVSS-TBSA. III. Results the time of antibiotic application, the duration of fever and the time of platelet decline in group B and C were shorter than those in group B and group C. The incidence of complications such as sepsis mods was lower than that of group B and C, and the frequency of dressing change was lower than that of group B and group C. the difference was statistically significant (P < 0.01), the incidence of septic mods and mods was lower than that of group B and C, respectively. Compared with group B and group C, group A had less pain, shorter healing time and hospitalization time, lower mean Vancouver scar score-body surface area at 3 and 12 months, slight scar hyperplasia and good joint movement. IV. Conclusion early eschar abrasion combined with acellular allogeneic skin covering can shorten the healing time of large area deep second degree burn wounds, reduce the occurrence of complications and improve the function after healing.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R644

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