摘要
目的探讨人工真皮联合自体薄层皮片移植对烧伤患者复合皮移植成活率及关节部位瘢痕状态的影响.方法前瞻性选取2017年8月至2019年8月保定市第五医院收治的94例烧伤患者作为研究对象,按照随机数字表法分为两组,各47例。对照组采取单纯中厚皮移植治疗,观察组采取人工真皮联合自体薄层皮片移植治疗。比较两组恢复情况(供皮区愈合时间、植皮区愈合时间、烧伤区痂下愈合时间及住院时间),治疗后随访6个月,比较两组复合皮移植成活率、创面愈合情况、关节部位瘢痕状态(VSS)评分、关节活动度(肩关节外展、膝关节屈、膝关节伸)、生存质量(BSHS-B)、心理状态(P0MS-SF)评分及并发症发生情况。结果观察组供皮区愈合时间、植皮区愈合时间、烧伤区痂下愈合时间及住院时间短于对照组(P<0.05)。观察组创面愈合情况优于对照组,复合皮移植成活率高于对照组(P<0.05)。治疗后,两组患者的关节部位瘢痕状态与治疗前比较均得到改善(P<0.05);观察组随访6个月关节部位瘢痕厚度、血管分布评分及VSS总分均低于对照组(P<0.05)。治疗后,两组患者的关节部位活动度与治疗前比较均得到改善(P<0.05);观察组肩关节外展、膝关节屈、膝关节伸活动度大于对照组(P<0.05)。治疗后,两组患者的生存质量和心理状态与治疗前比较均得到改善(P<0.05);观察组随访6个月BSHS-B评分高于对照组,P0MS-SF评分低于对照组(P<0.05)。观察组并发症发生率(4.26%)低于对照组(21.28%)(P<0.05)。结论人工真皮联合自体薄层皮片移植能显著提高烧伤患者复合皮移植成活率,进一步减轻患者关节部位瘢痕状态,降低并发症发生率,有效改善患者预后。
Objective To explore the effect of artificial dermis combined with autogenous thin skin graft on the survival rate of compound skin graft and the scar state of joints in burn patients.Methods 94 burned patients treated in Baoding Fifth Hospital from August 2017 to August 2019 were prospectively selected as the research objects.They were randomly divided into two groups with 47 cases in each group.The control group was treated with simple medium thick skin transplantation,and the obsenation group was treated with artificial demiis combined with autologous thin skin grafting.The recovery of the two groups(healing time of skin donor area,healing time of skin graft area,healing time under scab of burn area and hospitalization time)were compared.The survival rate of composite skin transplantation,wound healing,Vancouver Scar Scale(VSS)score,joint range of motion(shoulder abduction,knee flexion,knee extension),Bum Specific Health Scale-Brief(BSHS-B),Profile of Mood States-Short Form(POMS-SF)score and complications were compared.Results The healing time of donor area,skin graft area,subeschar healing time and hospital stay in the observation group were shorter than those in the control group(P<0.05).The wound healing in the observation group was better than that in the control group,and the survival rate of composite skin transplantation was higher than that in the control group(P<0.05).After treatment,the scar state of the joint in the two groups was improved compared with that before treatment(P<0.05);The scar thickness,vascular distribution score and total score of VSS in the observation group were lower than those in the control group(P<0.05).After treatment,the joint range of motion in the two groups was improved compared with that before treatment(P<0.05);The shoulder abduction,knee flexion and knee extension in the observation group were higher than those in the control group(P<0.05).After treatment,the quality of life and psychological status of the two groups were improved compared with those before treatment(P<0.05);The BSHS-B score of the observation group was higher than that of the control group,and the POMS-SF score was lower than that of the control group(P<0.05);The incidence of complications in the observation group(4.26%)was lower than that in the control group(21.28%)(P<0.05).Conclusions Artificial dermis combined with autologous thin skin graft can significantly improve the survival rate of compound skin graft in burned patients,and can further reduce the scar condition of the joints of patients,reduce the incidence of complications,and effectively improve the prognosis of patients.
作者
刘斌
周红霞
甄电伟
王香坤
李梅
郭艳谱
Liu Bin;Zhou Hongxia;Zhen Dianwei;Wang Xiangkun;Li Mei;Guo Yanpu(Department of Burn and Plastic Surgery,Baoding 5th Hospital,Baoding 071000,China)
出处
《中国医师杂志》
CAS
2021年第8期1153-1157,共5页
Journal of Chinese Physician
基金
河北省卫生健康委员会项目(20191229)。
关键词
烧伤
皮肤
人工
皮肤移植
移植
自体
瘢痕
Burns
Skin,artificial
Skin transplantation
Transplantation,autologous
Cicatrix
