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目的对比分析Meek植皮术联合碳纤维敷料与异体大张皮联合自体微粒皮移植治疗在大面积深度烧伤中的应用效果。方法纳入2013年1月至2016年1月河南省新乡市第二人民医院收治的大面积深度烧伤患者26例为研究对象,按治疗方案分组:观察组15例接受Meek植皮联合碳纤维敷料治疗;对照组11例应用异体大张皮联合自体微粒皮移植治疗。对比两组愈合效果、经济学指标及中期疗效。结果 (1)观察组术后7 d皮片存活率[(90.3±4.5)%vs(73.5±13.5)%]高于对照组、皮片融合时间[(13.5±2.3)d vs(18.6±3.7)d]短于对照组、创面愈合时间[(38.7±5.5)d vs(49.4±8.3)d]短于对照组(P均<0.01)。(2)观察组一次性专用敷料费用、住院总费用及后期康复费用均低于对照组(P均<0.01)。(3)所有患者行3~12(6.7±2.2)个月随访,观察组末次随访时疗效评价为优占86.7%,对照组末次随访时疗效评价为优仅占18.2%。观察组疗效明显好于对照组(P<0.01)。结论 Meek植皮联合碳纤维敷料对大面积深度烧伤有较确切的疗效及较好的社会经济效益。
Objective To compare the effect of Meek skin grafting combined with carbon fiber dressing and allogeneic autologous skin grafts in the treatment of large-area deep burn. Methods Twenty-six patients with extensive deep burn admitted to the Second People’s Hospital of Xinxiang City, Henan Province from January 2013 to January 2016 were divided into treatment group and control group. Fifteen patients in observation group were treated with Meek skin grafting combined with carbon fiber dressing. Group of 11 cases of allogeneic autologous skin grafting combined autologous skin graft. The healing effects, economic indicators and mid-term efficacy of the two groups were compared. Results (1) The survival rate in the observation group at 7 days after operation was significantly higher than that in the control group [(90.3 ± 4.5)% vs (73.5 ± 13.5)% vs (13.5 ± 2.3) d vs (18.6 ± 3.7) ) d shorter than the control group, the wound healing time was shorter than that of the control group [(38.7 ± 5.5) d vs (49.4 ± 8.3) d, P <0.01 respectively). (2) The cost of one-time special dressing, total cost of hospitalization and post-rehabilitation cost in the observation group were lower than those in the control group (all P <0.01). (3) All patients were followed up for 3 ~ 12 (6.7 ± 2.2) months. The curative effect was 86.7% at the final follow-up in the observation group and 18.2% at the last follow-up in the control group. Observation group was significantly better than the control group (P <0.01). Conclusion Meek skin graft combined with carbon fiber dressing has a more exact effect and a better social and economic benefit on extensive deep burn.