【摘 要】 目的 探討燒傷創面處理方法的優劣。方法 對192例輕至重度燒傷患者按照燒傷創面不同處理方法進行分組對比。結果 (1)濕潤暴露療法較包扎、干燥暴露療法滲出期有所延長(P<0.01),低蛋白血癥、休克發生率增加(P<0.05);(2)濕潤暴露療法較包扎、干燥暴露療法全身中毒癥狀明顯減輕并縮短(P<0.05),雖局部感染率增高,但在可容忍范圍(P<0.01);(3)濕潤暴露療法對燒傷創面基本沒有二次傷害(P<0.05);(4)治療中濕潤暴露療法可以明顯減輕患者疼痛,提高治療依從性(P<0.01);(5)濕潤暴露療法切削痂與創面保護一體,可以明顯減少植皮手術的需要?;蛘邉撛鞐l件,讓植皮手術時機后移到創面肉芽生長良好,基本填充真皮缺損時,以薄層皮片即可達到良好的功能要求,并減少瘢痕形成(P<0.05);(6)濕潤暴露療法應用得當,可以明顯縮短療程,降低醫療費用(P<0.05);(7)濕潤暴露療法可引發皮膚真菌感染,應引起注意。結論 本研究提示,采用(MEIBAO)濕潤燒傷膏涂抹后的藥物脫痂濕潤暴露療法,具有臨床處置簡便,患者依從度高,對醫院環境(如層流潔凈病房等)、醫院感染管理、醫師經驗等均要求不高,抗生素療程明顯縮短,用量減少,患者療程均縮短,功能恢復佳。適宜在基層醫院推廣。
【關鍵詞】 燒傷;創面處理;對比研究
【中圖分類號】 R644 【文獻標識碼】 A
Grouping Comparative Study on Wounds Treatment of Burn
Huang Qian Peng Yongliang
(The Third People's Hospital of Anyue County,Sichuan,Ziyang,642350)
【Abstract】 Objective To explore the method of burn wound treatment Pros and cons.Methods In 192 cases with mild to severe burn,burn wound were compared according to the different processing method.Results (1) Moist exposed therapy compared with Bandaging therapy and dry exposed therapy,exudative phase extension (P<0.01);Hypoproteinemia,shock incidence increased(P<0.05);(2) Moist exposed therapy compared with Bandaging therapy and dry exposed therapy,in systemic poisoning symptoms ease and shorten(P<0.05),although local infection rate increased, but in the tolerance range(P<0.01);(3) The moist exposed therapy on burn wound didn't hurt again(P<0.05);(4) During the treatment, moist exposed therapy can significantly reduce pain, improve treatment compliance(P<0.01);(5) Moist exposed therapy escharectomy,eschar and wound protection together,can significantly reduce the need for skin grafting operation.Or create conditions,make skin grafting operation time after the shift to granulation growth is good,basic filled dermal defect,use of the thin skin flap can achieve good functional requirements,and reduce scar formation(P<0.05);(6) Moist exposed therapy properly applied,can significantly shorten the course of treatment,reduce medical costs(P<0.05);(7) Therapy can cause skin fungal infection of moist exposed,should pay attention to. Conclusion This study suggests that,by(MEIBAO)drug moist burn cream after decrustation moist exposed therapy,clinical treatment is simple, high compliance of patients,the hospital environment (such as laminar flow ward),the hospital infection management, physician experience, etc,requirements are not high,a course of antibiotics is shortened obviously,reduce the dosage,patients period of treatment was shortened,good functional recovery.Suitable for promotion in the primary hospital.
【Keywords】 burn;wound treatment;comparative study
皮膚的主要功能是:阻擋外界異物和病原體入侵,防止體液丟失,感受外界刺激,調節體溫[1]。燒傷,特別是嚴重大面積燒傷的救治,我國一直處于世界前沿。皮膚是人體最大的器官,對創面進行的處理,就是最大的對因治療?!?br>