CAJ | 학술논문

目的：探讨J-1型异种脱细胞真皮和自体薄皮片复合移植在深度烧伤创面中的临床应用效果。方法选取2010年1月~2014年1月本院收治的应用J-1型异种脱细胞真皮和自体薄皮片复合移植修复深度烧伤创面的30例患者为观察组,另选择应用自体断层皮片修复深度创面的20例患者为对照组,观察比较两组的创面植皮存活率、术后6个月植皮皮肤色泽、皮肤厚度、血管分布情况、柔软度、瘢痕生长情况、功能部位活动情况,并用温哥华瘢痕评分量表(VSS)进行评分。数据采用SPSS 14.0统计学软件进行分析。结果观察组创面植皮存活率为(95±5)%,术后6个月植皮皮肤色泽评分为(1.64±0.38)分、厚度为(2.13±0.44)分、血管分布为(1.75±0.46)分、柔软度为(2.78±0.53)分,瘢痕增生不明显,功能部位活动正常。对照组创面植皮存活率为(74±7)%,术后6个月植皮皮肤色泽评分为(2.57±0.35)分、厚度为(2.92±0.48)分、血管分布为(2.69±0.56)分、柔软度为(4.36±0.68)分,瘢痕增生明显,3例患者功能部位活动受限。两组患者皮片存活率、VSS评分(色泽、厚度、血管分布、柔软度)差异有统计学意义(P<0.01)。结论异种脱细胞真皮和自体薄皮片复合移植既可解决患者自体皮源不足的问题,促进创面愈合,最大限度恢复患者皮肤的外观及功能,又能解决中厚皮或全厚皮供区遗留瘢痕的问题,值得进一步临床推广。
목적：탐토J-1형이충탈세포진피화자체박피편복합이식재심도소상창면중적림상응용효과。방법선취2010년1월~2014년1월본원수치적응용J-1형이충탈세포진피화자체박피편복합이식수복심도소상창면적30례환자위관찰조,령선택응용자체단층피편수복심도창면적20례환자위대조조,관찰비교량조적창면식피존활솔、술후6개월식피피부색택、피부후도、혈관분포정황、유연도、반흔생장정황、공능부위활동정황,병용온가화반흔평분량표(VSS)진행평분。수거채용SPSS 14.0통계학연건진행분석。결과관찰조창면식피존활솔위(95±5)%,술후6개월식피피부색택평분위(1.64±0.38)분、후도위(2.13±0.44)분、혈관분포위(1.75±0.46)분、유연도위(2.78±0.53)분,반흔증생불명현,공능부위활동정상。대조조창면식피존활솔위(74±7)%,술후6개월식피피부색택평분위(2.57±0.35)분、후도위(2.92±0.48)분、혈관분포위(2.69±0.56)분、유연도위(4.36±0.68)분,반흔증생명현,3례환자공능부위활동수한。량조환자피편존활솔、VSS평분(색택、후도、혈관분포、유연도)차이유통계학의의(P<0.01)。결론이충탈세포진피화자체박피편복합이식기가해결환자자체피원불족적문제,촉진창면유합,최대한도회복환자피부적외관급공능,우능해결중후피혹전후피공구유류반흔적문제,치득진일보림상추엄。
Objective To investigate the clinical application effect of J-1 type acellular dermis and antilogous trans-plantation in composite thin slices of deep burn wounds. Methods 30 cases of patients with depth burn wound (had no bone exposed) using J-1 type acellular dermis and antilogous thin piece composite graft repair treated in our hospital from January 2010 to January 2014 were selected as observation group,20 cases of deep burn wounds using antilogous skin grafts to repair the fault treated in our hospital at the same time were selected as control group.Graft survival rate, graft skin color,thickness,vascular distribution,softness,scar growth,functional parts of the activity after 6 months treat-ment were observed and compared between the two groups,and Vancouver scar scale (VSS) was used to assess the in-dexes.SPSS 14.0 statistical software was used for analysis. Results In observation group,the wound graft survival rate was (95±5)%,after 6 months treatment,the grafting skin color score was 1.64±0.38,thickness score was 2.13±0.44,vascu-lar distribution score was 1.75±0.46,softness score was 2.78±0.53,scar was not obvious,functional parts activity were normal.In control group,the wound graft survival rate was (74±7)%,after 6 months treatment,the grafting skin color score was 2.57±0.35,thickness score was 2.92±0.48,vascular distribution score was 2.69±0.56,softness score was 4.36±0.68, scar was obvious,3 cases of patients with functional parts activity limited.There were significant differences about wound graft survival rate and VSS scores (grafting skin color,thickness,vascular distribution and softness) between the two groups (P<0.01). Conclusion Acellular dermis and antilogous thin piece composite graft repair not only can solve inadequate source of antilogous skin problems,promote the wound healing,maximize restore the appearance and function of the patient’s skin,but also can solve thick or full-thickness skin donor site scar problems,is worthy of further clinical promotion.