中华烧伤杂志
中華燒傷雜誌
중화소상잡지
16
2009年
6期
448-450
,共3页
黄伯高%廖镇江%张勤%窦懿
黃伯高%廖鎮江%張勤%竇懿
황백고%료진강%장근%두의
烧伤%皮肤移植%混合嵌植%微粒皮移植
燒傷%皮膚移植%混閤嵌植%微粒皮移植
소상%피부이식%혼합감식%미립피이식
Burns%Skin transplantation%Intermingled skin transplantation%Microskin graft-ing
目的 了解大而积深度烧伤后混合皮肤嵌植与微粒皮移植疗效的差异. 方法 回顾性总结笔者单位1992-2008年17年间收治的101例大面积深度烧伤患者临床资料.将患者分为混合嵌植组52例、微粒皮组49例.比较2组患者首次自体供皮面积、首次自体皮覆盖创面面积,首次自体皮移植成活率、自体皮理论扩展倍数、自体皮实际扩展倍数、自体供皮总面积,以及术后残余创面情况、大关节功能状况等. 结果 混合嵌植组、微粒皮组的首次自体供皮面积分别为(3.25±0.48)%、(3.01±0.21)%TBSA,首次自体皮覆盖创面面积分别为(30.4±3.6)%、(41.4±1.3)%TBSA,首次自体皮移植成活率分别为(99.9±1.9)%、(87.5±6.8)%,自体皮理论扩展倍数分别为(9.5±1.3)、(13.9±1.4)倍,自体皮实际扩展倍数分别为(9.5±1.3)、(12.0±1.5)倍,上述指标组间比较,差异均有统计学意义(P<0.05);混合嵌植组、微粒皮组自体供皮总面积分别为(14.2±1.9)%、(14.0±2.1)%TBSA,2组比较,差异无统计学意义(P>0.05).混合嵌植组、微粒皮组残余创面超过0.5%TBSA者分别有23例占44.2%、37例占75.5%;混合嵌植组大关节功能状况较好者34例占65.4%,微粒皮组18例占36.7%. 结论 微粒皮移植法自体皮扩展倍数明显大于混合嵌植法,能更充分利用有限皮源;混合嵌植法创而愈合质量和大关节功能恢复状况优于微粒皮移植法.
目的 瞭解大而積深度燒傷後混閤皮膚嵌植與微粒皮移植療效的差異. 方法 迴顧性總結筆者單位1992-2008年17年間收治的101例大麵積深度燒傷患者臨床資料.將患者分為混閤嵌植組52例、微粒皮組49例.比較2組患者首次自體供皮麵積、首次自體皮覆蓋創麵麵積,首次自體皮移植成活率、自體皮理論擴展倍數、自體皮實際擴展倍數、自體供皮總麵積,以及術後殘餘創麵情況、大關節功能狀況等. 結果 混閤嵌植組、微粒皮組的首次自體供皮麵積分彆為(3.25±0.48)%、(3.01±0.21)%TBSA,首次自體皮覆蓋創麵麵積分彆為(30.4±3.6)%、(41.4±1.3)%TBSA,首次自體皮移植成活率分彆為(99.9±1.9)%、(87.5±6.8)%,自體皮理論擴展倍數分彆為(9.5±1.3)、(13.9±1.4)倍,自體皮實際擴展倍數分彆為(9.5±1.3)、(12.0±1.5)倍,上述指標組間比較,差異均有統計學意義(P<0.05);混閤嵌植組、微粒皮組自體供皮總麵積分彆為(14.2±1.9)%、(14.0±2.1)%TBSA,2組比較,差異無統計學意義(P>0.05).混閤嵌植組、微粒皮組殘餘創麵超過0.5%TBSA者分彆有23例佔44.2%、37例佔75.5%;混閤嵌植組大關節功能狀況較好者34例佔65.4%,微粒皮組18例佔36.7%. 結論 微粒皮移植法自體皮擴展倍數明顯大于混閤嵌植法,能更充分利用有限皮源;混閤嵌植法創而愈閤質量和大關節功能恢複狀況優于微粒皮移植法.
목적 료해대이적심도소상후혼합피부감식여미립피이식료효적차이. 방법 회고성총결필자단위1992-2008년17년간수치적101례대면적심도소상환자림상자료.장환자분위혼합감식조52례、미립피조49례.비교2조환자수차자체공피면적、수차자체피복개창면면적,수차자체피이식성활솔、자체피이론확전배수、자체피실제확전배수、자체공피총면적,이급술후잔여창면정황、대관절공능상황등. 결과 혼합감식조、미립피조적수차자체공피면적분별위(3.25±0.48)%、(3.01±0.21)%TBSA,수차자체피복개창면면적분별위(30.4±3.6)%、(41.4±1.3)%TBSA,수차자체피이식성활솔분별위(99.9±1.9)%、(87.5±6.8)%,자체피이론확전배수분별위(9.5±1.3)、(13.9±1.4)배,자체피실제확전배수분별위(9.5±1.3)、(12.0±1.5)배,상술지표조간비교,차이균유통계학의의(P<0.05);혼합감식조、미립피조자체공피총면적분별위(14.2±1.9)%、(14.0±2.1)%TBSA,2조비교,차이무통계학의의(P>0.05).혼합감식조、미립피조잔여창면초과0.5%TBSA자분별유23례점44.2%、37례점75.5%;혼합감식조대관절공능상황교호자34례점65.4%,미립피조18례점36.7%. 결론 미립피이식법자체피확전배수명현대우혼합감식법,능경충분이용유한피원;혼합감식법창이유합질량화대관절공능회복상황우우미립피이식법.
Objective To study difference in curative effect between intermingled skin transplanta-tion(IT)and microskin grafting(MG) in repairing massive deep burn. Methods Clinical materials of 101 patients with massive deep burn hospitalized from 1992 to 2008 were retrospectively summarized.Pa-tients were divided into IT group (n=52) and MG group(n=49).The size of initial donor site for autolo-gous skin,the wound size initially covered with autologous skin.the survival rate of initial autologous skin grafting,the theoretical expansion multiple of the autologous skin,the actual expansion multiple of the autol-ogous skin,the total size of donated autologous skin,the remained wound condition,and the function of large joint of patients in two groups were compared. Results In IT group and MG group,the size of initial donor site for autologous skin was respectively(3.25±0.48)%TBSA and(3.01±0.21)%TBSA,the wound size initially covered by autologous skin was respectively(30.4±3.6)%TBSA and(41.4±1.3)%TBSA,the survival rate of autologous skin grafting was respectively(99.9±1.9)%and(87.5±6.8)%,the theoretical expansion multiple of the autologous skin was respectively 9.5±1.3 and 13.9±1.4.the ac-tual expansion multiple of the autologous skin was respectively 9.5±1.3 and 12.0±1.5,the difference be-tween two figures of each index was statistically significant(P<0.05).There was no statistical significant difference between IT and MG group in respect of the total size of donated autologous skin [respectively (14.2±1.9)and(14.0±2.1)% TBSA,P>0.05].There were 23 patients(44.2%)with residual wounds over 0.5%TBSA in IT group,and 37 eases(75.5%)in MG group.There were 34 patients(65.4%) with good function of large joints in IT group,and 18 cases (36.7%) in MG group. Conclusions Ex-pansion multiple of autologous skin after MG is obviously larger than that after IT,thus limited skin source can be fully used.The wound healing quality and the restoration of large joint function of patients treated with IT are better than those of patients treated with MG.
