| 谢晓繁 陈冬梅 陈宇飞 邹晓防 蔡景宁 李宝龙.不同植皮方式修复大面积烧伤创面的临床效果分析[J].,2016,16(4):673-676 |
| 不同植皮方式修复大面积烧伤创面的临床效果分析 |
| The Clinical Effect of Different Ways of Skin Grafting in the Repairment ofLarge Area Burn Wounds |
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| DOI： |
| 中文关键词: 邮票植皮 meek 植皮 微粒皮 烧伤 修复 愈合 |
| 英文关键词: Stamp skin grafting Meek skin grafting Microskin Burn Repair Healing |
| 基金项目:国家自然科学基金项目(81501929) |
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| 中文摘要: |
| 目的：比较邮票植皮、meek 植皮以及自体微粒皮移植用于大面积烧伤患者创面修复的临床效果和可行性。方法：回顾性分析
我院烧伤科收治的120 例大面积烧伤患者的临床资料，根据不同的手术植皮方法分为微粒皮植皮组、Meek 植皮组和邮票皮组，
每组40 例。三组患者入院后均给予常规基础治疗，再根据选择植皮方式的不同实施微粒皮植皮、Meek 植皮和邮票皮植皮。对比
三组患者的植皮成活率、创面一期愈合率、愈合时间、死亡率、1%烧伤面积(1%TBSA)治疗费用(元)以及康复效果(康复优良率)。结
果：邮票皮组植皮成活率明显高于Meek 植皮组(P＜0.05)，Meek 植皮组植皮成活率明显高于微粒皮植皮组(P＜0.05)。Meek 植皮
组和邮票皮组创面愈合时间均明显短于微粒皮植皮组(P＜0.05)。邮票皮组1%TBSA治疗费用明显低于Meek 植皮组(P＜0.05)，
Meek 植皮组1%TBSA 治疗费用明显低于微粒皮植皮组(P＜0.05)。Meek 植皮组和邮票皮组的创面一期愈合率均明显高于微粒
皮植皮组(P＜0.05)；Meek 植皮组和邮票皮组的死亡率均明显低于微粒皮植皮组(P＜0.05)；meek 植皮组的瘢痕最轻，关节功能恢
复最好；微粒皮植皮组瘢痕最重，关节功能恢复最差。结论：不同植皮方式用于大面积烧伤创面修复的临床效果各不相同。邮票皮
成活率高、抗感染能力强，但扩张比例低，创面愈合效果差；meek 皮扩张比例高、康复效果好，但抗感染能力差；微粒皮扩张比例最
高，但成活率低，治疗成本高。临床上，应该根据患者的自身情况选择不同的植皮方式。 |
| 英文摘要: |
| Objective:To analyze the clinical effect and feasibility of stamp skin grafting, meek skin grafting and autologous
microskin in the treatment of patients with large area of burn wound.Methods:The clinical data of 120 cases of patients with large area
of burn wound who admitted in the burn Department of our hospital were given a retrospective analysis; they were divided into the
microskin graft group, meek skin grafting group and stamp skin group according to different skin grafting method, 40 cases in each
group. All the patients were given conventional treatment after admission, and then they were given microskin grafting, meek skin
grafting and stamp skin graft according to the choice of skin grafting ways.Results:The survival rate of stamp skin graft group was
significantly higher than that of meek skin grafting group (P<0.05), which was significantly higher in the meek skin grafting group than
that of microskin graft group (P<0.05); the wound healing time of meek skin grafting group and stamp skin group were significantly
shorter than that of microskin group (P<0.05); treatment cost of 1%TBSA of stamp skin group was less than that of meek skin grafting
group (P<0.05), but the treatment cost of 1%TBSA of meek skin grafting group was significantly less than that of the micro skin graft
group (P<0.05). The wound healing Ⅰ stage rate of meek skin grafting group and stamp skin group were significantly higher than that in
microskin graft group (P<0.05); mortality rate of meek skin grafting group and stamp skin group were lower than that of microskin graft
group (P<0.05); the scar of meek skin grafting group was the lightest, joint function recovered was the best; scar of microskin graft group
was the heaviest, the joint function recovery was the worst.Conclusion:The wound repair effect of different ways of skin grafting in a
large area burn were not identical, the survival rate of stamp skin was high, anti-infection ability was strong, but the expansion ratio was
low, wound healing effect wa poor; expansion ratio of Meek skin was high, healing effect was good, but the anti-infection ability was
poor; the expansion ratio of microskin was the highest, but the survival rate was low, treatment cost was high. Therefore, we should
choose different ways of skin grafting according to the patient's own situation. |
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