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目的:验证保留焦痂湿润皮簇内植培养技术对深Ⅲ度烧伤创面愈合与功能康复的有效性、安全性。方法:本研究选取有深Ⅲ度烧伤创面的患者120例,以深Ⅲ度烧伤创面作为研究样本,随机分为对照组与治疗组,对照组56例,91个创面,深Ⅲ度烧伤面积为(10.3±6.2)%TBSA,应用烧伤湿性医疗技术(MEBT/ MEBO)常规治疗;实验组64例,127个创面,深Ⅲ度烧伤(11.5±8.2)%TBSA,用保留焦痂湿润皮簇内植术(自体皮簇+MEBT/MEBO)治疗;观察指标为治疗前、后的临床症状、体征,局部红肿范围、疼痛程度、焦痂溶脱、发热、血白细胞及中性粒细胞、创面pH变化,每3天观察并记录一次,6天为1疗程,每疗程结束后进行初评;两个疗程后,每6天观察记录一次,7个疗程后积分评定疗效。结果:实验组平均疗程为36.85±2.81天,对照组41.95±3.19天,经t检验(P<0.005),两组治疗前后症状积分,经t检验P<0.005,组间均有非常显著性差异,提示湿润皮簇内植术疗效明显优于单纯MEBT/MEBO的疗效;实验组127个深Ⅲ度创面皮簇内植术后创面甲级愈合119个(93.7%),乙级愈合8个(6.3%);无丙级与丁级愈合创面;两组病人均未发生不良反应。结论:湿润皮簇内植术治疗深Ⅲ度烧伤创面愈合时间缩短、瘢痕形成较轻、功能康复良好,是一种安全、有效的治疗方法。
OBJECTIVE: To verify the effectiveness and safety of preserving eschar wetted implants in deep third degree burn wound healing and functional rehabilitation. Methods: In this study, 120 patients with deep third degree burn wounds were enrolled in this study. The deep third degree burn wounds were randomly divided into control group and treatment group. In the control group, there were 56 cases and 91 wounds. The area of deep third degree burn was ( 10.3 ± 6.2)% of TBSA were treated with conventional MEBT / MEBO. Tissue samples were obtained from 64 patients with 127 wounds and 11.5 ± 8.2% (Autologous skin tufts + MEBT / MEBO); the indexes were clinical symptoms, signs, local inflamed areas, degree of pain, estrous escaping, fever, leukocytes and neutrophils, Observation and record every 3 days, 6 days for a course of treatment, after the end of each course of the initial assessment; two courses of treatment, observation and recording every 6 days, 7 courses after the assessment of the efficacy of integration. Results: The average course of treatment was 36.85 ± 2.81 days in the experimental group and 41.95 ± 3.19 days in the control group. The t-test (P <0.005) showed that the symptom scores of the two groups before and after treatment were significantly different , Which suggested that the effect of wet-skin implants was better than that of MEBT / MEBO alone. In the experimental group, 119 wounds (93.7%) were healed after 127 deep third- 6.3%); no grade C and grade healed wounds; no adverse reactions occurred in both groups. Conclusion: Wet skin grafting is a safe and effective treatment for the treatment of deep third degree burn wounds with shortened healing time, less scar formation and good functional recovery.