中西医结合治疗大面积深度烧伤后残余创面

发布时间：2018-11-09 16:42

【摘要】：目的比较中药浸浴后中西医结合治疗与单纯应用磺胺嘧啶银霜治疗大面积深度烧伤后残余创面的临床效果。方法 2003年7月-2009年12月,将收治的128例大面积深度烧伤后残余创面患者随机分为两组。中西医结合治疗组70例(试验组):男45例,女25例;年龄18～60岁,平均38.6岁。致伤原因:火焰烧伤34例,钢水烧伤28例,化学灼伤8例。烧伤面积平均57.6%总体表面积(total body surface area,TBSA),残余创面平均7.4%TBSA。西医对照组58例(对照组):男50例,女8例;年龄20～59岁,平均37.9岁。致伤原因:火焰烧伤26例,热水烫伤12例,钢水烧伤16例,化学灼伤4例。烧伤面积平均56.5%TBSA,残余创面平均6.9%TBSA。两组患者一般资料比较,差异均无统计学意义(P0.05),具有可比性。试验组先行中药浸浴,然后采用中西药联合换药;对照组采用洗必泰溶液清洁创面后外涂磺胺嘧啶银霜。观察两组患者创面用药后疼痛缓解、创面愈合时间及瘢痕发生率。结果创面用药后试验组疼痛情况分级,优23例,良30例,中17例;对照组优17例,良20例,中13例,差5例,极差3例。试验组创面愈合时间为(13.45±4.74)d,较对照组的(23.87±14.45)d明显缩短。创面愈合2周后,试验组15例(21.4%)出现瘢痕,对照组35例(60.3%)出现瘢痕。以上指标两组比较,差异均有统计学意义(P0.05)。结论在中药浸浴基础上采用中西医结合治疗烧伤残余创面具有愈合快、疼痛轻、瘢痕少、住院时间短等优点,优于单纯应用磺胺嘧啶银霜疗法。
[Abstract]:Objective to compare the clinical effects of traditional Chinese medicine (TCM) combined with western medicine and sulfadiazine silver cream in treating residual wounds after large area deep burn. Methods from July 2003 to December 2009, 128 patients with residual wounds after extensive deep burn were randomly divided into two groups. There were 70 cases in the treatment group (experimental group): 45 males and 25 females, with an average age of 38.6 years (1860 years). The causes of injury were flame burns in 34 cases, molten steel burns in 28 cases and chemical burns in 8 cases. The average burn area was 57.6% total surface area (total body surface area,TBSA), and the residual wound area was 7.4TBSA. 58 cases of western medicine control group (control group): male 50, female 8, age 2059 years, mean 37.9 years old. The causes of injury were flame burn in 26 cases, hot water burn in 12 cases, molten steel burn in 16 cases, chemical burn in 4 cases. The average burn area was 56.5 TBSAs, and the residual wound was 6.9 TBSAs. Two groups of patients general data comparison, the difference is not statistically significant (P0.05), comparable. The experimental group was soaked with Chinese medicine and then changed by Chinese and western medicine, while the control group was treated with silver sulfadiazine cream after cleaning the wound with chlorhexidine solution. Pain relief, wound healing time and scar incidence were observed in both groups. Results in the experimental group, 23 cases were excellent, 30 cases were good, 17 cases were moderate, 17 cases were excellent, 20 cases were good, 13 cases were moderate, 5 cases were poor, and 3 cases were very poor. The wound healing time in the experimental group was (13.45 卤4.74) days, which was significantly shorter than that in the control group (23.87 卤14.45) days. After 2 weeks of wound healing, there were 15 cases (21.4%) with scar in the experimental group and 35 cases (60.3%) with scar in the control group. The difference between the two groups was statistically significant (P0.05). Conclusion the combination of traditional Chinese medicine and western medicine is superior to sulfadiazine silver cream in treating residual burn wounds with the advantages of quick healing, light pain, less scar and short hospital stay.
【作者单位】：南通大学第三附属医院烧伤整形科;
【分类号】：R644

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