三种植皮方式修复大面积烧伤创面的临床效果对照研究

目的 探讨不同植皮方式对大面积烧伤患者创面修复的临床效果及安全性.方法 选取2015年1月-2016年5月收治的132例均需植皮手术治疗的大面积烧伤患者作为研究对象,根据治疗方法将其分为A组、B组和C组,每组44例,所有患者均予烧伤常规治疗,A组患者予meek植皮术,B组患者予邮票皮植皮术,C组患者予以自体微粒皮联合异体大张皮移植术,分别比较3组患者术中、术后情况及康复效果.结果 A组和B组在术中输液总量、输注红细胞总量及手术时间均少于C组(P＜0.05).A组和B组的创面一期愈合率、植皮存活率、康复效果优良率均高于C组,死亡率和愈合时间低于C组(P＜0.05).且A组住院天数低于B组和C组,B组高于C组(P＜0.05).A组植皮存活率低于B组,康复效果优良率高于B组(P＜0.05).3组患者并发症发生率比较差异无统计学意义(P＞0.05).结论 不同的植皮的方式对大面积烧伤患者的临床效果及预后均不相同,临床上应根据患者的不同情况选择不同的植皮方式,以达到较满意的临床效果.

Comparison of Clinical Effect of Three Different Skin Grafting Methods in Repair of Wound Surface of Patients with Extensive Burns

Objective To investigate clinical effect and safety of different skin grafting methods in repair of wound surface of patients with extensive burns.Methods A total of 132 patients with extensive bums admitted between January 2015 and May 2016,who needed skin grafting,were divided into group A,B and C (n =44 for each group) according to different treatment methods.All patients were given routine treatment.Group A was given meek skin grafting;group B was given stamps skin grafting grafting;group C was given automicrograft skin grafting combined with large allograft skin grafting.Intraoperative and postoperative conditions and rehabilitation effects were compared in three groups.Results In group A and B,values of total amount of intraoperative transfusion,the total amount of red blood cells transfusion and operative time were significantly less than those in group C (P ＜ 0.05);primary healing rate of wound surface,survival rate of skin graft and excellent and good rate of rehabilitation effect were better,while values of mortality and healing time were lower than those in group C (P ＜ 0.05).Hospital stay in group A was shorter than that in group B and C,and the stay in group B was longer than that in group C (P ＜ 0.05).In group A,survival rate of skin graft was lower,while excellent and good rate of rehabilitation effect was better than those in group B (P ＜ 0.05).There were no significant differences in incidence rate of complications among the three groups (P ＞ 0.05).Conclusion Different skin grafting methods have different effects and prognosis on patients with extensive burns,and therefore clinicians should choose different skin grafting methods according to different patient conditions to achieve good effect.