CAJ | 학술논문

目的：探讨深Ⅱ度烧伤创面愈合后患者应用早期手术方法进行整形治疗对防治烧伤后瘢痕挛缩畸形及功能障碍的疗效。方法笔者选择2010年4月～2013年4月收治的40例深Ⅱ度烧伤创面愈合后进行早期功能部位整形手术患者，其中研究组22例，对照组18例。对照组采用常规治疗及功能锻炼，研究组在对照组基础上采取切除瘢痕组织，移植中厚皮并术后功能锻炼，比较两组治疗后的效果差异。结果研究组36个烧伤关节部位进行早期手术方法进行整形治疗后，各部位平均植皮存活率均达到90％以上，手和肩关节部位的植皮存活率较高。术后第3、6个月，两组患者的关节功能恢复效果分布情况比较差异不显著（P＞0.05），术后第12个月研究组患者的关节功能恢复显著优于对照组（P＜0.05），说明随着时间的延长，研究组患者采用功能部位整形术的远期效果较好。术后第12个月研究组的疗效分布显著优于对照组（P＜0.05），研究组的总有效率达到100％，显著高于对照组的80.65％（P＜0.05）。结论对深Ⅱ度烧伤创面愈合后患者应用早期手术方法进行整形治疗能够有效地改善患处瘢痕挛缩导致的关节功能障碍。
목적：탐토심Ⅱ도소상창면유합후환자응용조기수술방법진행정형치료대방치소상후반흔련축기형급공능장애적료효。방법필자선택2010년4월～2013년4월수치적40례심Ⅱ도소상창면유합후진행조기공능부위정형수술환자，기중연구조22례，대조조18례。대조조채용상규치료급공능단련，연구조재대조조기출상채취절제반흔조직，이식중후피병술후공능단련，비교량조치료후적효과차이。결과연구조36개소상관절부위진행조기수술방법진행정형치료후，각부위평균식피존활솔균체도90％이상，수화견관절부위적식피존활솔교고。술후제3、6개월，량조환자적관절공능회복효과분포정황비교차이불현저（P＞0.05），술후제12개월연구조환자적관절공능회복현저우우대조조（P＜0.05），설명수착시간적연장，연구조환자채용공능부위정형술적원기효과교호。술후제12개월연구조적료효분포현저우우대조조（P＜0.05），연구조적총유효솔체도100％，현저고우대조조적80.65％（P＜0.05）。결론대심Ⅱ도소상창면유합후환자응용조기수술방법진행정형치료능구유효지개선환처반흔련축도치적관절공능장애。
Objective To investigate the effect of early plastic surgery of functional sites on scar contrac-ture deformity and joint dysfunction in patients after wound healing of deepⅡdegree burn.Methods A total of 40 patients with deepⅡdegree burn after wound healing underwent early plastic surgery of functional sites in our hos-pital from Apr.2010 to Apr.2013 were selected with 22 cases as the study group and 18 cases as the control group. Patients in the control group received conventional treatment and functional exercise while patients in the study group received additional treatment of removal of scar tissues and transplantation of thick flaps as well as postoperative functional exercises.Differences of effects in the two groups after treatment were compared.Results Thirty-six burned joints in the study group achieved a survival rate of up to more than 90%after early surgical orthopedic treat-ment.The survival rate of hand and shoulder site was relatively higher.On the third and sixth months after surger-y,the difference of joint function restoration between the two groups was not significantly different(P>0.05).On the twelfth months after surgery,the joint function restoration of patients in the study group was significantly better than that of patients in the control group(P<0.05).This showed that the long-term effect of early plastic surgery was good.Twelve months after surgery,the distribution of efficacy of the study group reached 100%,which was sig-nificantly better than that of the control group(80.65%,P<0.05).Conclusion Early plastic surgery of functional sites can effectively improve joint dysfunction induced by scar contracture in the affected area.