摘要
目的 探讨深二度烧伤创面伤后24 h内削痂的可行性及其促进创面愈合的临床效果。方法19例烧伤总面积在200％～40％、以深二度为主的住院病人在伤后24 h内削痂;39例烧伤严重程度相似的病人在伤后3～5 d削痂作为对照。观察病人休克期的补液量、尿量、休克征象,回吸收期体温和心率,创面愈合时间以及并发症情况;同时对两组创面活检取材,进行组织学观察。结果 两组烧伤病人休克期补液量、尿量的比较均无差异(P>0.05);休克期后第1、2 d,对照组体温高于试验组(P<0.05);伤后24 h内削痂病人创面平均愈合时间(24.67±3.38)d,与对照组创面平均愈合时间(29.77±8.28)d比较明显缩短(P<0.05);组织学观察显示,经伤后24 h内削痂后,创面局部的炎症反应较对照创面明显减轻,创面组织未见进一步损害。结论烧伤后24 h内削痂对烧伤总面积在20％～40％、以深二度为主的成年病人是安全的,能通过改善局部过强的炎症反应而促进创面的愈合。
Objective To explore the feasibility and to evaluate the effects of tangential excision on deep partial thickness burn wound wilhin 24 h after injury. Methods Tangential excision on wound within 24 h after burn was carried out on 19 patients. Meanwhile, 39 patients suffered similar severe burn under took operation 3 - 5 d post injury as controls. The amount of infused fluid and urine as well as shock signs such as temperature, heart rate during shock period and after wound healing time were observed. The histopathological observation of the wounds between two groups was also carried out. Results It showed that there was no significant difference between two groups in the amount of infused fluid and urine. The average wound healing time (24.67 ±3.38) d significantly less than that (29.77±8.28) d in the control group(P < 0. 05), The temperature 2 d after shock lowered down more than the control group. The histopathological observation of the wounds in the study group showed that the inflammatory response was significantly decreased compared with that in the control group (P <0,05) , and the extent of tissue damage became limited. Conclusion The study reveals that tangential excision on deep partial thickness burn wound within 24 h is feasible, which may inhibit excessive inflammatory response and promotes wound healing.
出处
《上海第二医科大学学报》
CSCD
2004年第9期700-702,共3页
Acta Universitatis Medicinalis Secondae Shanghai
基金
国家重点基础研究发展规划项目(973项目)(G1999054205)
广西壮族自治区科技局厅科研项目(桂科基0161003)资助。
