再生医疗技术对深Ⅱ度烧伤患者的炎症因子水平及创面愈合的影响

唐强 黄志群 陆钢

[摘要]目的：探討联合应用亲水性纤维含银敷料辅助再生医疗技术对烧伤患者创面愈合及炎症反应的影响。方法：选择2015年3月-2019年1月在笔者医院进行治疗的烧伤患者240例，随机分为对照组和观察组。对照组采用亲水性纤维含银敷料治疗，观察组采用亲水性纤维含银敷料联合再生医疗技术进行治疗。对两组临床疗效、创面愈合及炎症反应影响进行评估比较。结果：观察组临床疗效分级比较显著优于对照组，差异有统计学意义（P<0.05）;但两组总有效率比较差异无统计学意义（P>0.05）。观察组患者创面愈合时间、肉芽组织生长时间显著短于对照组，差异有统计学意义（P<0.05）。治疗后，观察组患者血清TNF-α，IL-6及IL-10含量显著低于对照组，差异有统计学意义（P<0.05）。观察组不良反应发生率低于对照组，但组间比较差异无统计学意义（P>0.05）。观察组创面溶痂率一直高于对照组，观察组创面细菌培养阳性率显著低于对照组，差异有统计学意义（P<0.05）。结论：亲水性纤维含银敷料辅助再生医疗技术能够有效促进烧伤患者创面愈合，抑制炎性反应，从而改善烧伤患者预后。

[关键词]烧伤;深Ⅱ度;再生医疗技术;亲水性纤维含银敷料;创面修复;炎症反应

[中图分类号]R644    [文献标志码]A    [文章编号]1008-6455（2020）04-0094-04

Abstract： Objective  To investigate the effect of combined application of hydrophilic fiber silver dressing assisted regenerative medical technology on wound healing and inflammatory response in burn patients. Methods  From March 2015 to January 2019， 240 patients with burn were randomly divided into control group and observation group. The control group was treated with hydrophilic fiber silver dressing， while the observation group was treated with hydrophilic fiber silver dressing combined with regenerative medical technology. The clinical efficacy， wound healing and inflammatory response were evaluated in the two groups. Results  The clinical effect of the observation group was better than that of the control group， the difference was statistically significant（P<0.05）. But there was no significant difference in total effective rate between the two groups（P>0.05）. The wound healing time and granulation tissue growth time in the observation group were significantly shorter than those in the control group（P<0.05）. After treatment， the levels of TNF-α， IL-6 and IL-10 were significantly lower in the observation group than in the control group（P<0.05）. The incidence of adverse reactions in the observation group was lower than that in the control group， but there was no significant difference between the two groups（P>0.05）. The rate of escharectomy in the observation group was always higher than that in the control group， and the positive rate of bacterial culture in the observation group was significantly lower than that in the control group（P<0.05）. Conclusion  Hydrophilic fiber silver dressing can effectively promote wound healing and inhibit inflammatory reaction in burn patients， so as to improve the prognosis of burn patients.

Key words： burn; deep second degree; regenerative medical technology; hydrophilic fiber containing silver dressing; wound repair; inflammatory response

烧伤是日常生活中最为常见的一种机体损伤，特别是Ⅱ度以上深度烧伤，若不能及时处置或处置不当则会造成瘢痕组织增生，对于颈部、面部烧伤还会造成毁容，给患者的心理带来巨大负担的同时还会对患者将来的工作和生活造成严重影响[1-2]。亲水性纤维含银敷料（Aquacel Ag敷料）作为烧伤治疗的一种新型疗法，顺应性较好，便于根据实际需要进行相应修剪，同时可作为填充物，发挥引流作用，临床可用于深部伤口的治疗，更为重要的是其不需要每天更换，大大提高了患者临床治疗的依从性[3-4]。此外，再生……