摘要
目的初步观察微动力负压应用于小面积深Ⅱ度烧伤患儿创面的治疗效果。方法2016年1月一2018年8月,海军军医大学第一附属医院烧伤外科收治64例符合入选标准的小面积深II度烧伤患儿,进行前瞻性随机对照研究。按随机数字表法将患儿分为负压组[男18例、女14例,年龄(3.9±1.6)岁,烧伤总面积为(5.5 ±2.2)%体表总面积(TBSA)]和常规组[男20例、女12例,年龄(3.8 ±1.7)岁,烧伤总面积为(5.8 ±1.6)%TBSA],每组32例。2组患儿入院后即行简单清创,之后负压组患儿采用微动力负压治疗,每3 -5天更换1次负压材料;常规组患儿采用磺胺喀咗银乳膏行换药处理,隔日换药1次。于伤后14,21 d,对2组患儿行创面大体观察,计算创面愈合率,取创面分泌物行细菌培养并计算细菌阳性检出率。记录需要手术植皮的例数并计算手术植皮率,记录创面完全愈合时间。于创面愈合后3、6、12个月,采用温哥华瘢痕量表(VSS)评价瘢痕形成情况。对数据行X '检验,检验及Bonferroni校正、重复测量方差分析。结果(1 )伤后14 d,负压组患儿创面坏死组织全部被清除,分泌物较少,大部分创面已开始上皮化;常规组患儿大部分创面坏死组织被清除,分泌物多于负压组,创面愈合面积小于负压组。伤后21 d,负压组患儿大部分创面已愈合,分泌物较少;常规组患儿创面愈合面积明显小于负压组,分泌物多于负压组。(2)伤后14,21 d,负压组患儿创面愈合率[(49. 8 ± 3. 3)%、(95. 8 ± 2. 4)%]均明显高于常规组[(40. 0 ± 3. 2 )%、( 75. 3 ±2.5)%], t = 11.899 ,33.461, P <0.01o (3)伤后14,21 d,负压组患儿创面细菌阳性检出率均明显低于常规组(X?=6.275 ,5.741, P <0.05)。(4)负压组患儿手术植皮率明显低于常规组(χ^2 =5. 333,P <0.05)o (5)负压组患儿创面完全愈合时间为(23.9±2.3)d,明显短于常规组的(27.9±1.8)d( t =-7.806, P <0.01)o (6)创面愈合后3、6、12个月,负压组患儿VSS评分分别为
Objective To preliminarily observe the effects of application of micro-negative pressure in children with small-area deep partial-thickness burn. Methods From January 2016 to August 2018 , 64 children with small-area deep partial-thickness burn who were admitted to the Department of Burn Surgery of the First Affiliated Hospital of Naval Medical University were recruited in this prospective randomized controlled study. According to the random number table, they were divided into negative pressure group [18boys and 14 girls, aged (3. 9 ± 1.6 ) years with total burn area of (5.5 ±2.2)% total body surface area (TBSA)] and conventional group [ 20 boys and 12 girls, aged (3.8 ± 1.7) years with total burn area of (5.8 ± 1.6)% TBSA ], with 32 patients in each group. After admission, simple debridement was performed in the patients of 2 groups. After that, the children in negative pressure group were treated with micro-negative pressure with negative pressure material replaced every 3 to 5 days. Children in conventional group were treated with silver sulfadiazine cream with dressing change every other day. On post injury day ( PID ) 14 and 21 , general wound observation was performed, the wound healing rate was calculated, the exudates from the wounds were cultured and the positive detection rate was calculated. The number of patients requiring surgical skin grafting was recorded and the rate of surgical skin grafting was calculated , and the complete wound healing time was recorded in the patients of 2 groups. Scar formation was evaluated by the Vancouver Scar Scale ( VSS) in 3 , 6 , and 12 months after wound healing. Data were processed with chi-square test, t test, Bonferroni correction, and analysis of variance for repeated measurement. Results ( 1 ) On PID 14, all the necrotic tissue in the wounds of patients in negative pressure group was removed , with few exudates, and most of the wounds had been epithelialized;most of necrotic tissue in the wounds of patients in conventional group was removed, with more exuda
作者
郑小鹏
陈珏
陈甜胜
姜耀男
沈拓
肖仕初
胡晓燕
Zheng Xiaopeng;Chen Jue;Chen Tiansheng;Jiang Yaonan;Shen Tuo;Xiao Shichu;Hu Xiaoyan(Department of Burns and Plastic Surgery,the Naval Hospital of the Eastern Theater Command,Zhoushan316000,China;Out-patient Department,the First Affiliated Hospital,Naval Medical University,Shanghai 200433,China;Burn Institute of PLA,Department of Burn Surgery,the First Affiliated Hospital,Naval Medical University,Shanghai 200433,China)
出处
《中华烧伤杂志》
CAS
CSCD
北大核心
2019年第10期720-725,共6页
Chinese Journal of Burns
基金
全军医学科技青年培育项目(16QNP016).
关键词
负压伤口疗法
伤口愈合
瘢痕
小儿烧伤
Negative-pressure wound therapy
Wound healing
Cicatrix
Pediatric hums
