摘要
目的观察比较手部深度烧伤创面早期切削痂和晚期切削痂植皮手术的临床疗效。方法选择2012年7月—2016年6月间白求恩国际和平医院烧伤整形科收治的168例240只手部深度烧伤患者,按手术时间不同分为对照组和观察组,每组84例120只手。观察组采用早期(伤后3~5 d)行创面切削痂植皮手术治疗,对照组采用晚期(伤后7~14 d)行创面清创植皮术,观察比较2组术后并发症发生率、疼痛反应、愈合时间、外观及功能优良率等。结果观察组移植皮片的成活率高于对照组,感染发生率、术后疼痛感,瘢痕形成率及手部挛缩率均低于对照组,差异具有统计学意义(P<0.01),患者所有手部烧伤创面手术后均有不同程度的疼痛等不适,观察组术后疼痛VAS评分为(1.45±0.48)分,明显低于对照组的(2.89±0.69)分,差异具有统计学意义(t=18.77,P=0.000);观察组创面完全愈合时间为(13.73±5.8)d,明显短于对照组的(24.16±7.9)d,差异具有统计学意义(t=11.658,P=0.000)。手部外观和功能优良率高于对照组,差异均具有统计学意义(x^2=13.99,P<0.01)。结论早期实施切削痂手术治疗手部深度烧伤具有显著降低患者术后并发症的发生率、明显改善手部外观、恢复良好的手部功能、减轻疼痛和缩短创面愈合时间等优点。
Objective To observe the clinical effect of early escharectomy and delayed escharectomy in treating hand deep burns.Methods Two hundred and twenty patients hands with deep hand burns from 2012 July to 2016 June in Bethune International Peace Hospital were randomly divided into control group and observation group,each group of 84 patients.The observation group hands cutting scab skin grafting at 3 to 5day after bum injury,while control group cutting scab skin grafting at 7 to 14 day after burn injury,two groups were observed of hand complication rate,pain,healing time,appearance and function recovery differences.Results Compared with the control group,the observation group had lower complication rate,lower pain response,shorter healing time and higher appearance and function,the difference was statistically significant（P 〈0.01）.The VAS score in observation group was（1.45 ±0.48） point,which was significantly lower than that of control group（2.89 ±0.69）points,there was significant difference（t=18.77,P =0.000）.The healing time of the wound in observation group was（13.73 ±5.8）d,which was significantly shorter than of control group（24.16 ±7.9）d,there was significant difference（t =11.658,P =0.000）.The appearance and function recovery rate were higher than control group（x2 = 13.99,P 〈0.01）.Conclusion Early escharectomy in the treatment of deep hand bums has significantly advantages in reducing the incidence of postoperative complications,promoter appearance and better function,reduce the degree of pain,shorten wound healing time.
作者
王配合
何泽亮
李晓东
史少蕊
安亮恩
卓勤强
刘玲玲
WANG Peihe HE Zeliang LI Xiaodong SHI Shaorui AN Liangen ZHUO Qinqiang LIU Lingling.(Department of Burn and Surgery, Bethune International Peace Hospital, Shijiazhuang 050082, Chin)
出处
《疑难病杂志》
CAS
2017年第5期489-491,495,共4页
Chinese Journal of Difficult and Complicated Cases
基金
河北省医学科学研究重点课题计划项目(20160265)
关键词
手部深度烧伤
早期切削痂
晚期切削痂
植皮
Hand deep burns
Early escharectomy
Delayed escharectomy
Skin grafting
