| 曹 凤,李升红,黄海玲,刘 晖,严晓雯.削痂植皮术后结合负压封闭引流在深度烧伤患者中的应用效果及对血清致痛因子及炎性因子的影响[J].,2023,(7):1324-1328 |
| 削痂植皮术后结合负压封闭引流在深度烧伤患者中的应用效果及对血清致痛因子及炎性因子的影响 |
| Application Effect of Tangential Excision and Skin Grafting Combined with Vacuum Sealing Drainage in Patients with Deep Burn and its Effect on Serum Pain-Causing Factors and Inflammatory Factors |
| 投稿时间：2022-08-08 修订日期：2022-08-31 |
| DOI：10.13241/j.cnki.pmb.2023.07.024 |
| 中文关键词: 削痂植皮术 负压封闭引流 深度烧伤 创面愈合 植皮成活率 致痛因子 炎性因子 |
| 英文关键词: Tangential excision and skin grafting Vacuum sealing drainage Deep burn Wound healing Skin graft survival rate Pain-causing factors Inflammatory factors |
| 基金项目:广东省医学科研基金立项课题（B2020028） |
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| 中文摘要: |
| 摘要 目的：探讨削痂植皮术后结合负压封闭引流在深度烧伤患者中的应用效果及对血清致痛因子及炎性因子的影响，以此为临床治疗深度烧伤患者提供参考。方法：选取暨南大学附属第一医院在2018年1月至2022年1月期间收治的75例深度烧伤患者进行回顾性分析，所有患者均接受削痂植皮术治疗；按术后不同换药方法分为常规换药组和VSD组，其中常规换药组35例，术后常规换药；VSD组40例，术后采用VSD治疗。比较两组患者首次植皮成活率，术后1周、2周创面愈合率，创面愈合时间，疼痛程度及并发症发生率等，测定两组患者血清致痛因子、冲洗液炎性因子表达水平。结果：VSD组首次植皮成活率95.00%（38/40），常规换药组首次植皮成活率71.43%（25/35），差异有统计学意义（P<0.05）。VSD组术后1周、2周创面愈合率高于常规换药组，创面愈合时间、创面疼痛评分低于常规换药组，差异有统计学意义（P<0.05）。两组术后1周相关致痛因子表达较术前明显下降（P<0.05），且VSD组致痛因子表达低于常规换药组，差异有统计学意义（P<0.05）。两组术后1周冲洗液炎性因子表达低于术前（P<0.05），且VSD组冲洗液炎性因子表达与常规换药组比较下降明显，差异有统计学意义（P<0.05）。VSD组术后并发症发生率12.50%（5/40）低于常规换药组40.00%（14/40），差异有统计学意义（P<0.05）。结论：削痂植皮术后结合负压封闭引流技术可提高深度烧伤患者创面愈合效果，增加首次植皮成活率，减少细菌生成、炎性因子的释放，减轻创面疼痛程度，值得临床进一步研究。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the application effect of tangential excision and skin grafting combined with vacuum sealing drainage in patients with deep burn and its effect on serum pain-causing factors and inflammatory factors, so as to provide reference for clinical treatment of patients with deep burn. Methods: A retrospective analysis was performed on 75 patients with deep burns admitted to the The First Affiliated Hospital of Jinan University from January 2018 to January 2022. All patients underwent tangential excision and skin grafting. According to different dressing methods after operation, they were divided into routine dressing group and VSD group, including 35 cases in routine dressing group and routine dressing after operation. 40 cases in VSD group were treated with VSD after operation. The survival rate of first skin grafting at 1 week and 2 weeks, wound healing rate, wound healing time, pain degree and complication rate after operation were compared between the two groups. The expression levels of serum pain-causing factors and inflammatory factors in flushing fluid were measured. Results: The survival rate of the first skin grafting in the VSD group was 95.00% (38/40), and that in the conventional dressing group was 71.43 % (25/35), the difference was statistically significant (P<0.05). The wound healing rate of the VSD group was higher than that of the conventional dressing group at 1 and 2 weeks after operation, and the wound healing time and wound pain score were lower than those of the conventional dressing group, the differences were statistically significant(P<0.05). The expression of pain-causing factors in the two groups at 1 week after operation was significantly lower than that before operation(P<0.05), and the expression of pain-causing factors in the VSD group was lower than that in the conventional dressing group(P<0.05). The expression of inflammatory factors in flushing fluid in the two groups at 1 week after operation was lower than that before operation(P<0.05), and the expression of inflammatory factors in flushing fluid in the VSD group was significantly lower than that in the conventional dressing group(P<0.05). The incidence of postoperative complications in the VSD group was 12.50% (5/40) lower than that in the conventional dressing group 40.00% (14/40), and the difference was statistically significant (P<0.05). Conclusion: The combination of tangential excision and skin grafting combined with vacuum sealing drainage can improve the wound healing effect of deep burn patients, increase the survival rate of the first skin grafting, reduce the release of bacteria and inflammatory factors, and reduce the degree of wound pain, which is worthy of further clinical research. |
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