CAJ | 학술논문

目的：观察烧伤后24 h内削痂治疗老年深Ⅱ度烧伤的临床疗效及对机体炎症反应的影响。方法我院2010年1月至2013年12月收治82例老年深Ⅱ度烧伤患者,按照削痂治疗时间不同分为观察组(24 h内削痂治疗)和对照组(烧伤3~5 d行削痂治疗),比较2组患者烧伤后5 d内液体出入量、血清炎症因子水平变化、一次性植皮成活率、创面愈合时间、住院时间及并发症发生情况。结果2组患者烧伤后第1天、第5天平衡液、血浆输入量及尿量组间比较未见明显差异(P>0.05)；治疗后第3天开始观察组血清TNF-α水平与对照组相比明显降低(P<0.05),治疗后第1天开始IL-6水平与对照组相比明显降低,IL-10水平明显增高(P<0.05)；观察组一次性植皮成活率明显高于对照组,创面愈合时间和住院时间明显短于对照组(P<0.05)。观察组并发症发生率为11.1%,明显低于对照组的29.7%,差异具有统计学意义(P<0.05)。结论烧伤后24 h内早期削痂治疗能有效减轻患者局部组织炎症反应,减少创面感染概率,提高一次性植皮成功率,安全可靠。
목적：관찰소상후24 h내삭가치료노년심Ⅱ도소상적림상료효급대궤체염증반응적영향。방법아원2010년1월지2013년12월수치82례노년심Ⅱ도소상환자,안조삭가치료시간불동분위관찰조(24 h내삭가치료)화대조조(소상3~5 d행삭가치료),비교2조환자소상후5 d내액체출입량、혈청염증인자수평변화、일차성식피성활솔、창면유합시간、주원시간급병발증발생정황。결과2조환자소상후제1천、제5천평형액、혈장수입량급뇨량조간비교미견명현차이(P>0.05)；치료후제3천개시관찰조혈청TNF-α수평여대조조상비명현강저(P<0.05),치료후제1천개시IL-6수평여대조조상비명현강저,IL-10수평명현증고(P<0.05)；관찰조일차성식피성활솔명현고우대조조,창면유합시간화주원시간명현단우대조조(P<0.05)。관찰조병발증발생솔위11.1%,명현저우대조조적29.7%,차이구유통계학의의(P<0.05)。결론소상후24 h내조기삭가치료능유효감경환자국부조직염증반응,감소창면감염개솔,제고일차성식피성공솔,안전가고。
Objective To observe the clinical efficacy and inflammation of tangential excision within 24 hours after burn with massive deep Ⅱdegree burn wounds for elderly patients. Methods From Jan. 2010 to Dec. 2013, a total of 82 elderly patients with massive deepⅡdegree burn wounds were divided into the observation group ( giveing tangential excision within 24 hours after burn) and the control group ( giveing tangential excision within 3~5 d after burn) according the time of tangential excision treatment. The amount of infused fluid, u-rine, levels of serum inflammatory factors, survival rate of skin grafts, wound healing time, hospitalization time and the complications were compared between the two groups. Results There was no significant difference in the amount of infused fluid, plasma and urine between the two groups in the first day and fifth day (P>0. 05). The levels of TNF-αsignificantly decreased after 3 days of therapy compared with the control group (P<0. 05). The levels of IL-6 significantly decreased and IL-10 significantly increased from the first day of therapy in the ob-servation group compared with the control group (P<0. 05). The survival rate of skin grafts in the observation group was significantly higher than that in the control group, and time of wound healing and hospitalization in the observation group was significantly shorter than that in the control group (P<0. 05). The complication rate of the observation group was 11. 1% which was significantly lower than that in the control group 29. 7% (P<0. 05). Conclusion To treat burn with massive deepⅡdegree burn wounds for elderly patients with tangential excision within 24 hours which can effectively reduce the inflammatory, reduce wound infection and improve the success rate of skin grafting.