薄層削痂及井網(wǎng)劃痕術(shù)聯(lián)合封閉式負壓引流技術(shù)治療早期中小面積深Ⅱ度創(chuàng)面的臨床療效

　　[摘要] 目的 通過將薄層削痂及井網(wǎng)劃痕術(shù)與封閉式負壓引流技術(shù)創(chuàng)新性結(jié)合應用于早期中小面積深Ⅱ度創(chuàng)面的治療，觀察其對中小面積深Ⅱ度燒傷患者的臨床療效。 方法 采用病例對照研究，回顧性分析我科2015年2月～2017年6月期間收治的32例中小面積深Ⅱ度燒傷患者的臨床資料，其中新型手術(shù)方案為實驗組，傳統(tǒng)手術(shù)方案為對照組，每組16例，觀察比較兩組患者術(shù)后創(chuàng)面完全愈合時間、創(chuàng)面細菌培養(yǎng)陽性率、術(shù)后創(chuàng)口疼痛程度、住院時間及創(chuàng)面愈合質(zhì)量等指標并進行分析。 結(jié)果 實驗組患者術(shù)后創(chuàng)面完全愈合時間為（14.68±0.88）d；創(chuàng)面細菌培養(yǎng)陽性率術(shù)后14 d為（3.25±0.45）%，術(shù)后21 d為（0.31±0.48）%；創(chuàng)口疼痛評分術(shù)后14 d為（2.44±0.51）分，術(shù)后21 d為（0.31±0.46）分；住院時間為（20.66±0.86）d；Sawada瘢痕評分為（3.94±0.77）分。對照組創(chuàng)面完全愈合時間為（20.48±0.96）d；創(chuàng)面細菌培養(yǎng)陽性率術(shù)后14 d為（5.44±0.81）%，術(shù)后21 d為（2.19±0.78）%；創(chuàng)口疼痛評分術(shù)后14 d為（4.06±0.77）分，術(shù)后21 d為（1.75±0.46）分；住院時間為（28.18±1.38）d；Sawada瘢痕評分（6.94±0.78）分，組間比較差異有統(tǒng)計學意義（P<0.01）。 結(jié)論 新型手術(shù)方案應用于早期中小面積深Ⅱ度燒傷創(chuàng)面的治療，臨床上具有較多優(yōu)點，是中小面積深Ⅱ度創(chuàng)面治療較好的選擇。
　　[關(guān)鍵詞] 薄層削痂；井網(wǎng)劃痕術(shù)；VSD術(shù)；中小面積深Ⅱ度燒傷；創(chuàng)面愈合
　　[中圖分類號] R644 [文獻標識碼] A [文章編號] 1673-9701（2018）08-0007-05
　　The clinical effectiveness of treatment combining thinning tangential excision of eschar and gridding scratch operation and vacuum scaling drainage in patients with deep Ⅱdegree burn of medium and small area
　　XU Jianjun LI Linhui ZHANG Peng LIN Cai
　　Burn-Wound Center，the First Affiliated Hospital of Wenzhou Medical University，Wenzhou 325000，China
　　[Abstract] Objective To investigate the clinical effectiveness of the innovative early treatment combining thinning tangential excision of eschar and gridding scratch operation and vacuum scaling drainage（VSD）in patients with deep second-degree burn of medium and small area. Methods This was a case-control study. The clinical records of 32 patients with deep Ⅱdegree burn of medium and small area in our department from February 2015 to June 2017 were reviewed and analyzed. The patients who had been through the innovative surgery treatment were taken as case group and patients through the conventional surgery treatment as control group， with 16 patients in each group. The time of wound complete healing， positive rate of wound bacterial cultivation， degree of wound pain after surgery， the time of hospital stay and the quality of wound healing were compared and analyzed. Results In the case group， the time of wound complete healing was（14.68±0.88）days. The positive rate of wound bacterial cultivation 14 days after surgery was（3.25±0.45）% and it was（0.31±0.48）% 21 days after surgery. The wound pain score was（2.44±0.51）points 14 days after surgery and（0.31±0.46）points 21 days after surgery. The time of hospital stay was（20.66±0.86）days as well as the Sawada scar score （3.94±0.77）. In the control group， the time of wound complete healing was （20.48±0.96） days. The positive rate of wound bacterial cultivation 14 days after surgery was（5.44±0.81）% and it was （2.19±0.78）% 21 days after surgery. The wound pain score was（4.06±0.77）points 14 days after surgery and（1.75±0.46）points 21 days after surgery. The time of hospital stay was （28.18±1.38）days and the Sawada scar score（6.94±0.78）points. There was significant difference between two groups（P<0.01）. Conclusion There were many clinical advantages in applying the new surgery treatment of deep second-degree burn wound of medium and small area. It would be a good choice for patients with deep second-degree burn of medium and small area.

相關(guān)熱詞搜索：創(chuàng)面 薄層 引流 劃痕 封閉式