李 允



自体微粒皮植皮术不同扩展比对大面积、严重烧伤患者的干预效果

李 允

【摘要】目的 观察自体微粒皮植皮术不同扩展比对大面积、严重烧伤患者的干预效果。方法 选取66例大面积、严重烧伤患者，按随机数字表法分为对照组（33例）和观察组（33例）。两组患者均行自体微粒皮植皮术治疗，对照组患者采用1：12扩展比；观察组采用1：8扩展比。观察两组患者创面愈合优良情况，记录患者切痂创面愈合时间、住院时间、脓毒症发生率及病死率。结果 全体患者均顺利度过围术期，无死亡病例。观察组切痂创面愈合时间、住院时间［（36．42±3．23）、（42．56±4．37）］d均短于对照组［（48．62±4．17）、（55．49±3．64）］d（P＜0．05）；观察组创面愈合优良率90．90%比对照组69．70%高，脓毒症发生率3．03%比对照组18．18%低，两组比较差异均有统计学意义（P＜0．05）。结论 1：8扩展比自体微粒皮植皮术对大面积、严重烧伤患者的干预效果优于1：12扩展比，植皮创面愈合优良率高，切痂创面愈合快，脓毒症发生率低，能有效缩短康复时间。

【关键词】自体微粒皮植皮术；扩展比；严重烧伤

Objective To observe the effect of autologous microskin grafting in different expansion ratio on patients with large area and severe burn． Methods 66 patients with large area and severe burn were randomly divided into control group（33 cases）and observation group（33 cases）according to the random number table method． Two groups of patients were treated with autologous microskin grafting treatment，the control group were treated with 1：12 expansion ratio． Observation group by 1：8 expansion ratio． The wound healing was observed in the two groups． The wound healing time，length of stay，incidence rate and mortality rate of the patients were recorded． Results All patients were successfully passed the perioperative period，no death cases． The observation group cut scab wound healing time，hospitalization time （［（36．42±3．23）、（42．56±4．37）］d were significantly shorter than that of the control group ［（48．62±4．17）、（55．49±3．64）］d （P＜0．05）． Observation group of wound healing rate of 90．90% was higher than the control group 69．70%，sepsis rate of 3．03% was lower than 18．18%，two groups’differences were statistically significant （P＜0．05）． Conclusion 1：8 expansion ratio of autologous microskin grafting on large area and severe burn patients was significantly better than that of 1：12 expansion ratio． Skin wound healing rate was high，low incidence of sepsis， can effectively shorten the recovery time．

【Key words】 Autologous microskin grafting，Expansion ratio，Severe burns

大面积、严重烧伤会引起休克、水电解质及酸碱失衡、全身侵袭性感染等严重症状，其创面的修复一直是烧伤治疗的难点。临床治疗烧伤创面，多以去除创面坏死组织、修复切痂创面为主［1］。但因大面积、严重烧伤患者因自体皮源不足，因而需要多次进行取皮、植皮手术才能封闭创面，不仅操作麻烦，还会增加患者痛苦，甚至引起严重并发症发生。微粒植皮术是临床治疗大面积烧伤的有效措施，其在覆盖烧伤创面、减少全身感染及多器官功能衰竭方面有良好效果［2］。……