切痂、削痂植皮术对Ⅲ°关节烧伤患者局部微循环的影响及疗效观察

目的比较切痂、削痂植皮术对Ⅲ°关节烧伤患者局部微循环及疗效的影响。方法 96例Ⅲ°关节烧伤患者,按随机数字表法切痂植皮组、削痂植皮组各48例,分别经切痂或削痂后植皮,比较两组患者关节局部微循环指标（局部红细胞聚集、血管清晰程度、血流灌注量）及疗效。结果削痂植皮组总有效率为93.8%,切痂植皮组为77.1%,削痂组疗效优于切痂植皮组（P〈0.05）。削痂组开包后2 d、5 d及10 d的局部红细胞聚集情况及血管清晰程度、血流灌注量则均好于切痂植皮组（P〈0.05）,且削痂植皮组开包后5 d及10 d均优于开包后2 d（P〈0.05）。结论削痂植皮更有效改善植皮局部的微循环,提高临床疗效。

Impact of Different Skin Grafting Methods on Local Microcirculation and Efficacy in Patients with Severe Joint Burn

Objective To compare the effects of different skin grafting methods on local microcirculation and efficacy in patients with severe joint burn. Methods Ninety-six patients with severe joint burn were randomly divided into the escharectomy plus skin grafting group（ n = 48） and the eschar shaving plus skin grafting group（ n = 48）. The efficacy and local microcirculation indexes of patients＇ joints,including local erythrocyte aggregation,vascular clarity degree and blood perfusion,were compared between two groups. Results The total effective rate was 93. 8% in the eschar shaving plus skin grafting group,which was 77. 1% in the escharectomy plus skin grafting group,the efficacy of eschar shaving plus skin grafting group was higher than that of escharectomy plus skin grafting group（ P〈0. 05）. The local erythrocyte aggregation,vascular clarity degree and blood perfusion in the eschar shaving plus skin grafting group were superior to those in the escharectomy plus skin grafting group on the 2nd,5th and 10 th day after treatment（ P〈0. 05）,and in the eschar shaving plus skin grafting group,these indexes on the 5th and 10 th day after treatment were all better than those on the 2nd day after treatmen（ P〈0. 05）. Conclusion The eschar shaving and skin grafting can effectively improve the local microcirculation of patients with severe joint burn,with better clinical effects.