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目的研究全厚皮片移植及大张厚中厚皮移植对烧伤后手外形功能恢复的疗效。方法 46例Ⅱ~Ⅲ度手烧伤患者,随机分为观察组和对照组,各23例。观察组采用全厚皮片移植术治疗,对照组采用大张厚中厚皮移植治疗,术后随访观察2年,比较两组患者手外形功能恢复效果。结果观察组术后6个月手外形功能恢复优良率为86.96%,高于对照组的60.87%,差异有统计学意义(P<0.05)。术后随访2年,两组优良率比较差异无统计学意义(P>0.05)。结论全厚皮片移植和大张厚中厚皮移植均是治疗手深度烧伤的有效手段,远期疗效较好;但全厚皮片移植对患者术后早期改善手活动度,缓解瘢痕、挛缩畸形和色素沉着症状等方面明显更优。
Objective To study the curative effect of full-thickness skin grafts and large-thickness thick-skinned grafts on post-burn hand shape recovery. Methods 46 cases of Ⅱ ~ Ⅲ degree hand burn patients were randomly divided into observation group and control group, 23 cases each. The observation group was treated with full-thickness skin grafts, while the control group was treated with large-thick and medium-thickness skin grafts. The postoperative follow-up was observed for 2 years. The hand shape recovery was compared between the two groups. Results The excellent and good rate of hand contour function recovery in observation group was 86.96% at 6 months after operation, which was significantly higher than that in control group (60.87%, P <0.05). After 2 years of follow-up, there was no significant difference in the excellent and good rates between the two groups (P> 0.05). Conclusion Full-thickness skin grafts and large-thickness thick-skinned skin grafts are both effective methods for the treatment of deep-hand burns, and the long-term curative effect is good. However, full-thickness skin grafts can improve hand mobility early after operation and relieve scarring, contracture deformity and Pigmentation symptoms were significantly better.