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目的 探讨治疗大面积深Ⅱ度烧伤创面的新手术方法。 方法 将 5 5例大面积深Ⅱ度烧伤患者随机分成两组 ,A组为微创性磨擦组 (30例 ) ,B组为削痂组 (2 5例 )。A组首次手术时间为伤后 (12 .3± 10 .7)h ,B组为 (4 7.2± 11.5 )h。以患者的尿量、心率和动脉血氧饱和度 (SaO2 )作为主要监测指标。结果 A组患者一次性磨擦面积为 (6 5 .5± 19.4 ) %TBSA ,B组一次性削痂面积为(6 4 .8± 18.7) %TBSA。术中、术后各项监测指标均较平稳 ,与条件相似的B组比较 ,A组创面愈合时间平均为 2 0d ,较B组缩短 10d左右 ;内脏并发症及菌血症发生率低 (A组 2 6 .7% ,B组 72 0 % ) ;平均住院费用下降 ,愈合后创面瘢痕明显减轻。 结论 休克早期 ,采用微创性磨擦的方法治疗大面积深Ⅱ度烧伤创面 ,具有操作简便、损伤轻、感染率低、并发症少、创面愈合快等特点 ,是一种较好的早期处理创面的方法。
Objective To explore a new surgical method for treating deep second degree burn wounds in large area. Methods Fifty-five patients with deep second-degree deep burn were randomly divided into two groups. Group A was minimally invasive (30 cases) and group B (35 cases). The first operation time in group A was (12.3 ± 10.7) h after injury and (4 7.2 ± 11.5) h in group B. The patient’s urine output, heart rate and arterial oxygen saturation (SaO2) as the main monitoring indicators. Results The group A had a one-off frictional area of (65.5 ± 19.4)% TBSA, while the group B had a one-off tweezers area of (64.4 ± 18.7)% TBSA. During and after operation, all the monitoring indexes were relatively stable. Compared with group B with similar conditions, the mean wound healing time of group A was 20 days, which was about 10 days shorter than group B. The incidence of visceral complications and bacteremia was low (A 26.7% in group B and 72.0% in group B). The average cost of hospitalization decreased and the wound scar significantly reduced after healing. Conclusions In the early stage of shock, the minimally invasive method for the treatment of deep second degree burn wounds has the advantages of simple operation, light injury, low infection rate, less complications and faster wound healing, which is a good early treatment of wounds Methods.