摘要
目的探讨异体脱细胞真皮与自体刃厚皮复合移植一期修复面部Ⅲ度烧伤创面的临床治疗效果。方法2004年6月～2010年1月收治的面部Ⅲ度烧伤创面均一期行植皮手术的患者72例，单纯自体皮移植的为对照组48例，包括：自体刃厚皮移植组（对照组A）28例，自体中厚皮移植组（对照组B）20例；异体脱细胞真皮与自体刃厚皮复合移植的为干预组24例。对治疗后植皮成活率、皮下血肿率、残余创面发生率、瘢痕修复等结果进行统计学比较分析。结果①干预组制皮存活率为87．5％，对照组A为89．3％，对照组B为90．O％，组间比较发现，三组存活率差异不明显（P〉0．05），无统计学意义。②并发症发生隋况如下，干预组皮下血肿为2例（8．3％），残余创面发生为2例（8.3％），对照组A分别为6例（21．4％）和5例（17．9％），对照组B分别为2例（10．0％）和1例（5．0％），经组问比较发现，干预组明显优于对照组A（P〈0．05），与对照组B差异不明显（P〉0．05）；干预组发生1例植皮区瘢痕修复（4．2％），对照组A瘢痕修复1例（3．6％），对照组B为10例（50．O％）。瘢痕修复发生率方面，干预组与对照组A差异不明显（P〉0．05），但明显优于对照组B（P〈0．05）。③干预组与对照组B在R2及R5弹I生参数指标差异不明显（P〉0．05），但明显高于对照组A（P〈0．05），差异有统计学意义。结论异体脱细胞真皮与自体刃厚皮复合移植，术后皮下血肿少，植皮成活率高，弹性好，远期效果满意度高等诸多优点，为临床治疗面部大面积深度烧伤提供参考。
Objective To investigate the clinical therapeutic efficacy of primary repair of III facial burn wound by cografting of allogeneic acellular dermal matrix and autologous split-thickness skin. Methods 72 cases with III facial burn wound were divided into 2 groups： 24 underwent cografting of allogeneic acellular dermal matrix and autologous split-thickness skin （intervention group）, and 48 patients received simple autologous skin graft, 28 of which received autologous thin split-thickness graft （control group A） and 20 cases of which received autologous intermediate split thickness skin graft （control group B）. The subcutaneous hematoma rate, skin graft survival rate, the residential wound rate and the scarring rate were compared and analyzed after treatment. Results ① The graft survival rate of the intervention group was 87.5%, not significantly different from those of the control group A （89.3%） and control group B （90.0%） （both P〉0.05）.② The subcutaneous hematoma rate of the intervention group was 8.3%, significantly lower than that of the control group A （21.4%, P〈0.05）, but not significantly different from that of the control group B （10.0%, P 〉0.05）. The residential wound rate of the intervention group was 8.3%, significantly lower than that of the control group A （17.9%, P 〈0.05）, but not significantly different from that of the control group B （5.0%, P 〉0.05）. The scarring rate of the intervention group was 4.2%, significantly lower from that of the control group B （50.0%, P〈0.05）, but not significantly different from that of the control group A （3.6%, P 〉0.05）. ③ The R2 elastic parameter of the intervention group was （0.519 ± 0.12）, significantly higher than that of the control group A [（0.569 ± 0.09）, P 〈0.05], but not significantly different from that of the control group B [（0.702±0.22）, P 〉0.05]. The R5 elastic parameter of the intervention group was （0.675 ± 0.14）, significantly higher than that of the contro
出处
《中国急救复苏与灾害医学杂志》
2013年第2期139-142,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
关键词
面部Ⅲ度烧伤
肉芽组织创面
异体脱细胞真皮
单纯自体皮植皮
III facial bums wound
granulation tissue
allogeneic acellular dermis
Autologous splitthickness skin
