中国烧伤创疡杂志
中國燒傷創瘍雜誌
중국소상창양잡지
2013年
3期
233-236
,共4页
湿润烧伤膏%下肢慢性溃疡%恶变%治疗
濕潤燒傷膏%下肢慢性潰瘍%噁變%治療
습윤소상고%하지만성궤양%악변%치료
MEBO Ointment%Chronic ulcer of lower limb%Malignant transformation%Treatment
目的 观察湿润烧伤膏( MEBO)在下肢慢性溃疡恶变中的治疗效果.方法 患者入院后,对创面予以病理活检、微生物培养、摄片等检查后,对创面局部纤维板给予划开清除,逐层削除老化、纤维化肉芽组织,使创面形成相对“新鲜”状态后,采用 MEBO换药治疗(每6 h换药1次),重新培育肉芽组织;全身给予抗感染、改善微循环等治疗.创面肉芽组织成熟后,再次多点活检病理检查,确认创面无明显癌组织后,行“邮票式”植皮手术、周围曲张静脉结扎及分段剥脱术,供皮区使用 MEBO油纱换药治疗;术后5 d,植皮区改用MEBO油纱包扎换药治疗,每日1次,直至创面完全愈合.结果 供皮区创面于术后14 d愈合,植皮区创面于术后30 d痊愈,愈后随访4年,创面轻度瘢痕增生,无新的溃疡创面形成及转移癌发生.结论 MEBO是肉芽组织生长的“培养基”,能促进慢性溃疡创面的愈合,是慢性溃疡创面修复的良好外用药.另外, MEBO可能影响体表肿瘤的生物特性,抑制肿瘤细胞生长.
目的 觀察濕潤燒傷膏( MEBO)在下肢慢性潰瘍噁變中的治療效果.方法 患者入院後,對創麵予以病理活檢、微生物培養、攝片等檢查後,對創麵跼部纖維闆給予劃開清除,逐層削除老化、纖維化肉芽組織,使創麵形成相對“新鮮”狀態後,採用 MEBO換藥治療(每6 h換藥1次),重新培育肉芽組織;全身給予抗感染、改善微循環等治療.創麵肉芽組織成熟後,再次多點活檢病理檢查,確認創麵無明顯癌組織後,行“郵票式”植皮手術、週圍麯張靜脈結扎及分段剝脫術,供皮區使用 MEBO油紗換藥治療;術後5 d,植皮區改用MEBO油紗包扎換藥治療,每日1次,直至創麵完全愈閤.結果 供皮區創麵于術後14 d愈閤,植皮區創麵于術後30 d痊愈,愈後隨訪4年,創麵輕度瘢痕增生,無新的潰瘍創麵形成及轉移癌髮生.結論 MEBO是肉芽組織生長的“培養基”,能促進慢性潰瘍創麵的愈閤,是慢性潰瘍創麵脩複的良好外用藥.另外, MEBO可能影響體錶腫瘤的生物特性,抑製腫瘤細胞生長.
목적 관찰습윤소상고( MEBO)재하지만성궤양악변중적치료효과.방법 환자입원후,대창면여이병리활검、미생물배양、섭편등검사후,대창면국부섬유판급여화개청제,축층삭제노화、섬유화육아조직,사창면형성상대“신선”상태후,채용 MEBO환약치료(매6 h환약1차),중신배육육아조직;전신급여항감염、개선미순배등치료.창면육아조직성숙후,재차다점활검병리검사,학인창면무명현암조직후,행“유표식”식피수술、주위곡장정맥결찰급분단박탈술,공피구사용 MEBO유사환약치료;술후5 d,식피구개용MEBO유사포찰환약치료,매일1차,직지창면완전유합.결과 공피구창면우술후14 d유합,식피구창면우술후30 d전유,유후수방4년,창면경도반흔증생,무신적궤양창면형성급전이암발생.결론 MEBO시육아조직생장적“배양기”,능촉진만성궤양창면적유합,시만성궤양창면수복적량호외용약.령외, MEBO가능영향체표종류적생물특성,억제종류세포생장.
@@@@ Objective To observe the efficacy of MEBO in treating malignant transformation of chronic lower limb ulcer. Methods After admission, the wound was examined by pathological biopsy, microbial culture, and imaging. Per-form excision on the local wound fibreboard, excising degenerated and fibrotic granulation tissues layer by layer, exposing the“ fresh” wound surface. Then apply MEBO on the wound and change dressing once every 6 hours, cultivating new granu-lation tissue; systemic anti-infection and microcirculation improvement therapy were performed. When wound granulation tissue matured, multiple site pathological biopsy exam was taken to confirm there was no obvious wound tissue canceration. Then perform“ stamp” skin grafting and peripheral varicose ligation&segmented peeling surgery; the donor site wound was treated with MEBO gauze dressing change. Five days post operation, wound at skin grafting site was treated with bandaged MEBO gauze dressing change once a day till complete wound healing. Results Wounds of donor sites healed 14 days after operation and wounds of skin grafting healed 30 days after operation. Four-year follow-up after wound healing found mild proliferation of scar but no new ulceration or metastatic cancer. Conclusion MEBO Ointment is the“ culture medium” pro-moting the growth of granulation tissue and can promote the healing of chronic ulcers, and thus is an excellent external drug for wound repair of chronic ulcer. Moreover, MEBO Ointment may influence the biological features of superficial tumor, in-hibiting the growth of tumor cells.
