半暴露干-湿疗法治疗小儿Ⅱ度烧伤的临床研究

目的:探讨半暴露干-湿疗法治疗小儿Ⅱ度烧伤的优点及临床价值。方法:从2007年3月～2008年3月收治符合条件患者共141例,可供观察部位(四肢)227处,其中浅Ⅱ度创面146处,深Ⅱ度81处。根据创面处理方法不同随机分成A(干-湿疗法)、B(干性疗法)、C(湿性疗法)3组。观察各组创面经治疗后:①水肿渗出期持续时间(天);②创面有否继发感染;③创面有否进行性损害并加深;④是否需手术植皮治疗;⑤创面完全愈合时间(天);⑥药物对小儿的安全性。结果:体液渗出期持续时间比较;A组及B组创面处理方法相同,持续时间无显著性差异(P>0.05),C组无论是浅Ⅱ度或深Ⅱ度渗出期均较A组持续时间长,两组比较有显著性差异(P(0.01)。完全愈合时间比较;在浅Ⅱ度创面,A组完全愈合时间为(9.5±2.2)天,B组为(10.8±2.3)天,C组为(11.6±3.4)天,A组分别与B、C组比较显示有显著性差异(P(0.01),在深Ⅱ度创面,A组时间为(20.2±5.1)天,B组为(22.4±5.6)天,C组为(22.8±6.2)天,A组分别与B、C组比较显示有显著性差异(P(0.01)。结果表明A组临床治疗效果明显好于B、C组。结论:半暴露干-湿疗法治疗Ⅱ度烧伤的特点在于根据不同时期烧伤创面的不同病理特点,有针对性的选用药物,以保持创面外环境的相对稳定,从而促进创面愈合,避免创面进行性损害,减少深Ⅱ度创面植皮手术的机率,减少瘢痕形成,是一种较为细化的创面处理方法,适合应用于小儿病例。

Clinical Study of the Therapy of Partial-wrapping and Dry-moist on Partial-thickness Burn Wounds of Juvenal Patient

Objective: To study the therapeutic effect of the therapy of partial-wrapping and dry-moist on treatment with juvenal patient who suffer partial-thickness burn wounds.Methods: From 2007 March to 2008 March there were 227 partial-thickness burn wounds provided by 141 juvenal patients,include 146 superficial-partial-thickness burns and 81 deep-partial-thickness burn wounds,to be randomized into A group(dry-moist therapy) and B group(dry therapy) and C group(moist therapy) according to the variant treatment to the wounds.The duration of hydropsia period,the secondary infection of the wounds,the secondary impairment of the wounds,whether to need dermatoplasty,the wound healing time and the effect and safety of the drug to Juvenal patient were studied in these three groups.Results: Compare with A and B groups,which the treatment were identical in hydropsia period,the duration weren't significant difference(P>0.05).On the contrary,compare with A and C groups,there were significant difference(P〉0.01)about duration of hydropsia period.For superficial-partial-thickness burns,the average wound healing time of A group was(9.5±2.2)days,B group was(10.8±2.3)days,and C group was(10.8±2.3)days,which both shows significant difference(P〈0.01)when compared A to B or A to C.For deep-partial-thickness burns,the average wound healing time of A group was(20.2±5.1)days,B group was(22.4±5.6)days,and C group was(22.8±6.2)days,which also both shows significant difference(P〈0.01)when compared A to B or A to C.These results mean that A group got a better therapeutic effect.Conclusion: The feature of the therapy of partial-wrapping and dry-moist for partial-thickness burn wounds might be to apply different drug on different period of partial-thickness burn which result from different pathologic reaction.The therapy get advantages of maintaining a stabilization of wound's external environment,facilitating wound healing,obviating the secondary impairment of the wounds,reducing dermatoplasty rate,reducing synulosis,which is fit for the juvenal patient.