复合皮移植技术与传统方法治疗烧伤后大面积瘢痕效果比较

周靳 陈婧颖 涂小磊 彭友林

【摘要】 目的：研究复合皮移植技术与传统方法治疗烧伤后大面积瘢痕的效果。方法：选取笔者所在医院收治的72例烧伤后大面积瘢痕患者作为研究对象，按照信封法随机分为两组，每组36例。对照组采用反复切取后躯干瘢痕皮修复，观察组采用复合皮移植技术。比较两组创面愈合时间、创面周围炎症反应积分、OSAS评分。结果：观察组创面愈合时间短于对照组，差异有统计学意义（P<0.05）;观察组治疗2、4周后创面周围炎症反应积分均高于对照组，OSAS评分均低于对照组，差异均有统计学意义（P<0.05）。结论：同传统方法相比较，复合皮移植技术治疗烧伤后大面积瘢痕的效果更为显著。

【关键词】 烧伤 大面积瘢痕 复合皮移植技术

doi：10.14033/j.cnki.cfmr.2019.28.071 文献标识码 B 文章编号 1674-6805（2019）28-0-02

Effect of Composite Skin Transplantation and Traditional Method in the Treatment of Large Area Scar after Burn/ZHOU Jin， CHEN Jingying， TU Xiaolei， PENG Youlin. //Chinese and Foreign Medical Research， 2019， 17（28）： -167

[Abstract] Objective： To study the effect of composite skin transplantation and traditional methods in the treatment of large area scar after burn. Method： Seventy-two patients with large area scars after burns were enrolled in this study. They were randomly divided into two groups according to the envelope method， 36 cases in each group. The control group used repeated removal of scar skin from the posterior trunk. The observation group used composite skin transplantation. Wound healing time， inflammatory response scores around the wound， and OSAS scores were compared between the two groups. Result： The wound healing time in the observation group was shorter than that of the control group， and the difference was statistically significant （P<0.05）. And 2 and 4 weeks after treatment， the scores of inflammatory response around the wounds in the observation group were higher than those of the control group， and OSAS scores were lower than those of the control group， and the differences were statistically significant （P<0.05）. Conclusion： Compared with the traditional method， the composite skin transplantation is more effective in treating large area scars after burns.

[Key words] Burns Large area scar Composite skin transplantation

First-authors address： The Central Hospital of Xiaogan， Xiaogan 432000， China

瘢痕是創伤后患者创口愈合的正常生理反应[1]。烧伤后大面积瘢痕会对患者的形象、生活质量产生影响[2]。烧伤后大面积瘢痕的修复治疗是整形外科正在研究的重点问题。以往采用的网状植皮、混合植皮存在质地差、耐磨性差等问题，容易出现坏死、感染、功能障碍等情况[3]。因此，临床需要寻找更加安全、有效的瘢痕修复方法。本文对复合皮移植技术的应用效果进行分析，以反复切取后躯干瘢痕皮修复作为对照，旨在为临床治疗烧伤后大面积瘢痕提供参考依据，正文阐述如下。

1 资料与方法

1.1 一般资料

从2017年4月-2018年3月笔者所在医院接收的烧伤后大面积瘢痕患者中选取72例开展研究。纳入标准：（1）均确诊为深Ⅱ度或Ⅲ度烧伤，符合临床关于大面积瘢痕的诊断标准;（2）既往身体健康且营养状况良好;（3）无酗酒、药物依赖情况。排除标准：（1）存在免疫系统疾病、血液系统疾病、凝血机制障碍;（2）存在严重心脑血管疾病、肝脏及肾脏疾病;（3）存在恶性肿瘤;（4）入组前已接受过与研究相关治疗措施。……