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目的观察评估皮肤原位再生疗法治疗复合伤患者烧伤创面的疗效和安全性。方法 41例复合伤患者在积极治疗合并伤的同时,对烧伤创面采用皮肤原位再生疗法治疗,同时给予抗感染、抗休克及营养支持等对症治疗,观察创面治疗效果。结果除1例患者因严重颅脑损伤于治疗第3天死亡,1例患者在治疗第2天时死于创伤性休克外,余39例患者均康复出院。平均愈合时间:浅Ⅱ度创面为10.3 d±1.9 d,深Ⅱ度创面为19.8d±2.4 d,Ⅲ度创面为32.5 d±6.4 d。15例深Ⅱ度烧伤患者中有3例患者创面愈合后留有轻度瘢痕,但不影响功能,余12例患者创面无明显瘢痕形成;治愈的39例患者中有11例患者创面愈合后遗留色素沉着;所有患者在治疗过程中均无明显疼痛及其他不良反应,且抗感染效果显著。结论采用皮肤原位再生疗法治疗复合伤患者烧伤创面,能够减轻患者疼痛,预防感染,较好地保护与修复创面,解决复合伤创面在治疗时机上相互冲突的问题,为严重复合伤患者烧伤创面的治疗提供了一种新的疗法。
Objective To evaluate the efficacy and safety of skin in situ regenerative therapy in the treatment of burn wounds in patients with complex wounds. Methods Forty-one patients with combined injuries underwent active treatment of combined injuries and skin in situ regenerative therapy. Anti-infection, anti-shock and nutritional support were also given to treat the wounds and the effect of wound healing was observed. Results One patient died of severe brain injury on the third day of treatment, one patient died of traumatic shock on the second day of treatment, and more than 39 patients were recovered and discharged. The average healing time was 10.3 d ± 1.9 days for shallow Ⅱ degree wound, 19.8 ± 2.4 days for deep Ⅱ degree wound and 32.5 ± 6.4 days for Ⅲ degree wound. Three of 15 patients with deep second degree burn remained mild scars after wound healing but did not affect the function. No scar formation was found in the wounds of the remaining 12 patients. Eleven of the 39 cured patients left behind after wound healing Pigmentation; all patients in the course of treatment were no obvious pain and other adverse reactions, and the anti-infection effect is significant. Conclusion The method of skin in situ regenerative therapy for the treatment of burn wounds in patients with multiple injuries can reduce pain and prevent infection, protect and repair the wounds well, and solve the conflicting problems in timing of treatment. The treatment provides a new kind of therapy.