本文選題：大面積燒傷 + 深Ⅱ度��； 參考：《安徽醫(yī)科大學(xué)》2016年碩士論文

【摘要】：一.研究目的探討早期磨痂聯(lián)合脫細(xì)胞異種皮覆蓋術(shù)在大面積(大于50%TBSA)深Ⅱ度燒傷中的臨床療效。二.研究方法回顧性分析安徽醫(yī)科大學(xué)解放軍174醫(yī)院2009年9月~2013年9月收治入院的大面積深Ⅱ度燒傷60例患者,早期補液抗休克后行早期磨痂術(shù)+異種皮覆蓋治療(A組)20例,早期磨痂術(shù)+納米銀醫(yī)用抗菌敷料覆蓋治療(B組)20例和保守?fù)Q藥(C組)20例,觀察術(shù)后抗生素應(yīng)用時間、發(fā)熱持續(xù)時間、血小板下降時間、并發(fā)癥發(fā)生率、疼痛程度、創(chuàng)面愈合時間、住院時間、3個月及12個月瘢痕評分等指標(biāo),瘢痕評分采用m VSS-TBSA。三.結(jié)果早期磨痂術(shù)聯(lián)合脫細(xì)胞異種皮覆蓋組術(shù)后抗生素應(yīng)用時間、發(fā)熱持續(xù)時間、血小板下降時間較B組和C組均縮短,差異有統(tǒng)計學(xué)意義(P均0.01);膿毒癥、MODS等并發(fā)癥發(fā)生率較B組和C組為低(P0.05);換藥次數(shù)較B組、C組減少。與B組和C組比較,A組患者疼痛程度較輕、愈合時間及住院時間縮短,3個月及12個月平均溫哥華瘢痕評分—體表面積均降低,瘢痕增生輕、關(guān)節(jié)活動度好。四.結(jié)論早期磨痂術(shù)聯(lián)合脫細(xì)胞異種皮覆蓋術(shù)能縮短大面積深Ⅱ度燒傷創(chuàng)面愈合時間,降低并發(fā)癥的發(fā)生,改善愈后功能。
[Abstract]:I. Objective to investigate the clinical effect of early scab abrasion combined with acellular xenoclast covering on large area (> 50 TBSAs) deep second degree burn. II. Methods A retrospective analysis of 60 patients with large area deep second degree burn admitted to PLA 174 Hospital of Anhui Medical University from September 2009 to September 2013 was carried out. 20 patients in group A were treated with early scab skin covering after fluid resuscitation. Early scab grinding with nano-silver medical antibacterial dressing was performed in 20 patients in group B and 20 patients in group C with conservative change of medicine. The time of antibiotic application, duration of fever, time of platelet decline, incidence of complications and degree of pain were observed. Wound healing time, hospitalization time, scar score at 3 and 12 months, and scar score were measured by mVSS-TBSA. III. Results the time of antibiotic application, the duration of fever and the time of platelet decline in group B and C were shorter than those in group B and group C. The incidence of complications such as sepsis mods was lower than that of group B and C, and the frequency of dressing change was lower than that of group B and group C. the difference was statistically significant (P < 0.01), the incidence of septic mods and mods was lower than that of group B and C, respectively. Compared with group B and group C, group A had less pain, shorter healing time and hospitalization time, lower mean Vancouver scar score-body surface area at 3 and 12 months, slight scar hyperplasia and good joint movement. IV. Conclusion early eschar abrasion combined with acellular allogeneic skin covering can shorten the healing time of large area deep second degree burn wounds, reduce the occurrence of complications and improve the function after healing.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R644

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