Meek植皮与邮票植皮在大面积深度烧伤创面修复中的疗效比较

邓斌 李蔓青 张拥军

[摘要]目的：探討Meek植皮技术在大面积深度烧伤中的近远期疗效。方法：选取2013年8月-2017年8月笔者医院收治的104例大面积深度烧伤患者为研究对象，随机分为观察组与对照组，各52例。对照组行邮票植皮术进行治疗，观察组行Meek植皮技术进行治疗，术后随访24个月。比较两组患者手术指标及治疗效果，统计术后并发症发生情况及对治疗的满意度。结果：观察组手术时间、皮片融合时间、创面愈合时间、住院时间、供皮面积、植皮面积率及手术费用均显著少于对照组，差异有统计学意义（P<0.05）。观察组术后12个月、24个月的皮片成活率均显著高于对照组，差异有统计学意义（P<0.05）。观察组患者瘢痕增生、关节功能障碍及新生皮肤薄等并发症总发生率显著低于对照组，差异有统计学意义（P<0.01）;术后观察组患者治疗总满意度显著高于对照组，差异有统计学意义（P<0.01）。结论：Meek植皮技术在大面积深度烧伤中的近远期疗效均显著优于传统的邮票植皮术，且术后患者满意度较高，并发症发生率低，值得推广。

[关键词]大面积深度烧伤;Meek植皮;邮票植皮;皮片;近远期疗效;并发症

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2019）07-0066-03

Comparison of Meek Skin-grafting with Stamp-grafting in the Repair of Large-area Deep Burn Wounds

DENG Bin1，LI Man-qing1，ZHANG Yong-jun2

（1.Department of General Surgery，Gucheng Hospital of Traditional Chinese Medicine，Xiangyang 441700，Hubei，China;

2.Department of Cardiothoracic Surgery，Xiangyang Central Hospital，Xiangyang 441021，Hubei，China）

Abstract： Objective  To investigate the short-term and long-term effects of Meek skin grafting in the treatment of patients with large area deep burn. Methods  104 patients with large area deep burn admitted to our hospital from August 2013 to August 2017 were selected and divided into the observation group and the control group randomly， 52 cases were for each group. Control group was treated with stamp skin grafting， observation group was treated with Meek skin grafting technique， and followed-up for 24 months postoperation. The operation indexes and therapeutic effect of the two groups of patients were compared， the occurrence of complications and the satisfaction of treatment in two groups of patients postoperation were counted. Results  The operation time， skin fusion time， wound healing time， hospitalization time， skin donor area， skin graft area rate and operation cost of the observation group were significantly less than those of the control group， and the difference was statistically significant（P<0.05）. The survival rate of skin grafts in the observation group at 12 and 24 months after operation was significantly higher than that in the control group（P<0.05）. The total incidence of complications such as scar hyperplasia， joint dysfunction and new skin thinning in the observation group was significantly lower than that in the control group（P<0.01）. The total satisfaction of patients in the observation group was significantly higher than that in the control group（P<0.01）. Conclusion  The short-term and long-term effect of Meek skin grafting in the treatment of patients with large area deep burn is significantly better than that of traditional stamp skin grafting. The postoperative patients' satisfaction is higher and the incidence of complications is lower. It is worth popularizing the operation.

Key words： large area deep burn; Meek skin grafting; stamp-grafting; skin graft; short-term and long-term effect; complications

大面积烧伤作为可危及患者生命的重大意外性伤害一直备受临床关注，如何以较少的自体皮源修復较大创面成为治疗的难点与重点。若未能对患者创面及时进行封闭可引发感染、免疫功能损伤等并发症，严重者甚至可发生死亡[1-2]。目前大面积烧伤的主要治疗方法包括邮票皮移植、网状皮片植皮、微粒皮移植、自体皮移植等。……