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目的:探讨严重烧伤患者Meek植皮术后皮片存活情况的影响因素及其预测价值。方法:2013年1月—2019年12月,陆军军医大学(第三军医大学)第一附属医院收治115例符合入选标准的严重烧伤且行Meek植皮治疗的患者(男95例、女20例,年龄1~74岁),对其进行病例对照研究。将患者分为皮片存活率≥70%的皮片存活良好组(68例)和皮片存活率最佳阈值组和独立危险因素≤最佳阈值组,采用n χ2检验对比Meek植皮术后皮片存活不良发生率,计算Meek植皮术后皮片存活不良的相对危险度。n 结果:行1∶1 PSM前,2组患者性别、年龄、体重指数、合并吸入性损伤情况、伤后手术时间及术前半胱氨酸蛋白酶抑制剂C水平、白蛋白水平、中性粒细胞百分比、血红蛋白水平比较,差异均无统计学意义(n P>0.05);皮片存活不良组患者Ⅲ度烧伤面积、烧伤指数均明显高于皮片存活良好组(n Z=-2.672、-2.882,n P0.05); the full-thickness burn area and burn index of patients in poor skin graft survival group were significantly higher than those in good skin graft survival group (n Z=-2.672, -2.882, n P<0.01); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group (n Z=-3.411, -3.050, -2.748, -2.686n , P0.05); the preoperative platelet count and the platelet count on the first, third, and fifth day after operation of patients in poor skin graft survival group were significantly lower than those in good skin graft survival group (n Z=-3.428, -2.940, n t=-2.427, -2.316, n P<0.05 orn P<0.01). Multivariate logistic regression analysis showed that only the preoperative platelet count was an independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients (odds ratio=0.994, 95% confidence interval=0.989-0.998,n P<0.01). The area under the ROC curve of preoperative platelet count predicting poor skin graft survival after Meek grafting in 92 patients was 0.707 (95% confidence interval=0.603-0.798,n P98×10n 9/L group (n χ2=10.376, n P98×10n 9/L group, patients in preoperative platelet count≤98×10n 9/L had a relative risk of poor skin graft survival after Meek grafting of 2.211 (95% confidence interval=1.263-3.870).n Conclusions:Preoperative platelet count is an independent risk factor affecting the skin graft survival after Meek grafting in severe burn patients, and has a good predictive value. Meek grafting should be performed with caution when the preoperative platelet count of patients is≤98×10n 9/L.n