CAJ | 학술논문

目的评估导入透明质酸的反复冻融结合超声振荡法制备的脱细胞羊皮应用于大面积烧伤治疗的临床疗效.方法回顾性分析2011年6月至2013年9月行自体微粒皮联合异种皮移植术的5例患者的临床资料,患者均为男性,年龄33 ～ 50岁,平均烧伤面积83％±11％,其中Ⅲ度创面60％～ 90％.患者入院后按照大面积烧伤常规治疗中流程进行液体复苏、气道管理、创面处理、控制感染等治疗,待休克期度过后,血流动力学稳定时行微粒皮联合脱细胞羊皮复合移植手术.对异种脱细胞真皮在大面积烧伤治疗中的可行性及手术操作技术进行总结.结果 5例患者全部存活,休克期度过平稳,未发生严重的肺部感染、肾衰竭、创面脓毒症、败血症等严重合并症,共行9次微粒皮手术,覆盖17个肢体.平均脱细胞真皮脱落时间(17.7±2.7)d,接受手术次数(7.4±1.1)次,残余创面＜5％时间为(72±6)d,总住院时间(115 ±27)d.结论导入透明质酸的脱细胞羊皮可替代异体皮联合自体微粒皮复合移植应用于大面积烧伤的治疗.
목적 평고도입투명질산적반복동융결합초성진탕법제비적탈세포양피응용우대면적소상치료적림상료효.방법 회고성분석2011년6월지2013년9월행자체미립피연합이충피이식술적5례환자적림상자료,환자균위남성,년령33 ～ 50세,평균소상면적83％±11％,기중Ⅲ도창면60％～ 90％.환자입원후안조대면적소상상규치료중류정진행액체복소、기도관리、창면처리、공제감염등치료,대휴극기도과후,혈류동역학은정시행미립피연합탈세포양피복합이식수술.대이충탈세포진피재대면적소상치료중적가행성급수술조작기술진행총결.결과 5례환자전부존활,휴극기도과평은,미발생엄중적폐부감염、신쇠갈、창면농독증、패혈증등엄중합병증,공행9차미립피수술,복개17개지체.평균탈세포진피탈락시간(17.7±2.7)d,접수수술차수(7.4±1.1)차,잔여창면＜5％시간위(72±6)d,총주원시간(115 ±27)d.결론 도입투명질산적탈세포양피가체대이체피연합자체미립피복합이식응용우대면적소상적치료.
Objective To evaluate the clinical efficacy of the goat acellular dermal matrix combined with hyaluronic acid (h-GADM) in the treatment of major burns.Methods A retrospective analysis of 5 patients with major burns undergoing combines microskin and h-GADM grafting.All patients were male,aged 33 to 50 years,and mean burn area were 83％ ± 11％,which Ⅲ degree wounds 60％ to 90％.After extensive burns patients admitted to hospital in accordance with conventional treatment processes included fluid resuscitation,airway management,wound management,infection control and other treatment.The patients received the surgery after the shock of spending and hemodynamically stable.Summarized the feasibility and operative techniques of the new method,and elaborated on details by a typical case as an example.Results All the 5 patients were survival,go through the shock period smoothly,not haven any serious complications as lung infection,wound sepsis,septicemia and kidney failure occurred.A total of nine mircoskin graft operations were undergoing and covered 17 limbs.The average time of the h-GADM desquamtion was (17.7 ± 2.7) days after operation,the hospitalization time was (115 ± 27) days.After (72 ±6) days,the residual wound was less than 5％ total body surface area.Conclusion The h-GAMD can be a good alternative to cadaver skin in the treatment of major bums.