摘要
目的:了解近10年来改进并应用于临床的全身及局部治疗措施在提高大面积烧伤病人治愈率的同时,是否对创面愈合速度也产生了影响。方法:将1970年以来我科收治的大面积烧伤病人657例,以1990年1月为界分为两组,对比分析全身创面综合治疗措施改进前后,创面侵袭性感染发生率、植皮成活率,创面愈合速度的变化。1990年开始改进并应用于临床的全身性治疗措施包括器官功能保护、合理营养支持、创面感染有效控制、生长激素应用等;创面方面包括尽早切痂植皮、胶原酶促进脱痂、促愈药物银锌霜和生长因子等积极干预手段。结果:1990年后创面侵袭性感染发生率显著降低;植皮成活率显著提高;创面愈合时间显著缩短。创面基本愈合时间和痊愈时间较前分别提前了20天和22天。结论:全身和创面局部治疗手段的进步极大地促进了大面积烧伤病人创面愈合时间,减轻了病人的痛苦。
Objective:To determine whether improved systemic and local treatment measures in the past two decades have any positive effect on wound healing speed in patients sustained extensive burn injury. Methods: 657 extensively burned patients were involved in this retrospective study. Incidence of invasive wound infection, grafttake rate, and wound healing time were compared between patients admitted before and after Jan, 1990 when improved treatment measures began to be adopted. Systemic measures of the improved regime included early organ function protection, rational nutritional support, effective wound infection control, and the use of growth hormone. Wound treatment measures composed of early escharectomy followed by coverage of viable skin (some in shock stage), debridement of devitalized tissues with collagenase, use of Zn agent (SD-Ag-Zn), and topival use of growth factors such as b-FGF and EGF. Results: The incidence of invasive wound infection was significantly lower and graft-take rate significantly higher in patients admitted after 1990 than that admitred before 1990. Basic wound healing time (the total area of remaining wounds<3%) and total healing time were shorter by 20 and 22 days, respectively, during the later period. Conclusion: With the progress in systemic supporting techniques and wound management measures, the healing rate of the wounds in severely burned patients was greatly accelerated.
出处
《感染．炎症．修复》
2001年第1期25-27,共3页
Infection Inflammation Repair
关键词
大面积烧伤
创面愈合
综合治疗
Extensive burns Wound healing Systemic treatment
