彭杨 秦花 梁琼

[摘要]目的：探討局部氧疗合并可调节负压创面治疗技术（Local oxygen therapy combined with regulated negative pressure-assisted wound therapy，RONPT）治疗深Ⅱ度烧伤创面的疗效。方法：以笔者医院2017年9月-2019年12月收治的50例烧伤患者为研究对象，根据入院时间先后分别进入治疗组和对照组，各25例。治疗组患者在常规处理后，早期（48h）运用RONPT治疗;对照组患者除不进行RONPT外，其余治疗均按常规深Ⅱ度烧伤创面治疗方案进行。比较两组患者致病菌检出率、创面愈合情况、血清中炎性因子的水平及并发症发生情况。结果：治疗组致病菌检出率明显低于对照组，差异有统计学意义（P<0.05）。治疗组患者创面愈合天数（20.68±3.14）d少于对照组（32.89±4.25）d，差异有统计学意义（P<0.05）。观察组创面愈合率（96.48±6.89）%明显高于对照组（81.17±5.74）%，差异有统计学意义（P<0.05）。治疗组血清中炎性因子IL-4、TNF-α水平低于对照组，差异有统计学意义（P<0.05）。治疗组并发症发生率少于对照组，但组间比较差异无统计学意义（P>0.05）。结论：综合治疗联合RONPT在烧伤治疗中具有较好的安全性和有效性。所有患者后期均进行6～8个月随访，既能有效清除坏死组织，又能最大限度地保留间生态上皮组织，愈合时间、愈合质量等方面均存在明显优势，值得临床推广。

[关键词]烧伤;局部氧疗合并可调节负压创面治疗技术;创面修复;愈合;炎性因子;并发症

[中图分类号]R644    [文献标志码]A    [文章编号]1008-6455（2021）06-0027-03

Local Oxygen Therapy Combined with Regulated Negative Pressure-assisted Wound Therapy in the Treatment of Deep Second Degree Burn Wounds

PENG Yang，QIN Hua，LIANG Qiong

（Medical Department，the First Affiliated Hospital of Chengdu Medical College，Chengdu 610500，Sichuan， China）

Abstract： Objective  To investigate the effect of local oxygen therapy combined with regulated negative pressure-assisted wound therapy（RONPT） in the treatment of deep second degree burn wounds. Methods  A total of 50 burn patients treated in our hospital from September 2017 to December 2019 were selected as the research objects. According to the admission time， they were divided into the treatment group and the control group， 25 cases in each group. Patients in the treatment group were treated with RONPT in the early stage （48h） after routine treatment. The patients in the control group were treated according to the conventional deep second degree burn wound treatment scheme except RONPT. The detection rate of pathogenic bacteria， wound healing， serum levels of inflammatory factors and complications were compared between the two groups. Results  After treatment， the detection rate of pathogens in the treatment group was significantly lower than that in the control group， the difference was statistically significant （P<0.05）. The number of wound healing days （20.68±3.14）d in the treatment group was less than that in the control group [（32.89±4.25）d， P<0.05]. The wound healing rate （96.48±6.89）% in the treatment group was significantly higher than that in the control group [（81.17±5.74）%， P<0.05]. The inflammatory level in the treatment group was lower than that in the control group （P<0.05）. The incidence of complications in the treatment group were less than the control group， but there was no significant difference between the two groups （P>0.05）. Conclusion  The comprehensive treatment combined with RONPT has better safety and effectiveness in the treatment of burns. All patients were followed up for 6 to 8 months at the later stage， which can effectively remove necrotic tissue and preserve mesenchymal epithelium to the maximum extent. There are obvious advantages in terms of the number of dressing changes， the length of hospital stay， the healing time， and the quality of healing. It is worthy of clinical promotion.

Key words： burns; local oxygen therapy combined with regulated negative pressure-assisted wound therapy（RONPT）; wound healing; heal; inflammatory factors; complication

Ⅱ度烧伤，尤其深Ⅱ度烧伤，是烧伤患者中较为常见的类型。积极促使创面早期愈合，能极大程度上减轻患者痛苦，提高生活质量[1]。现有单一的治疗难以达到满意的疗效，迫切需要在治疗上有新的突破。既往的研究结果显示[2-4]，传统早期治疗深Ⅱ度烧伤存在以下不足：①创面修复环境不理想，感染几率增加;②常规处理包扎后，创面处于一个局部缺血、缺氧、组织水肿、渗出较多的状态，愈合较差;③由于渗出水肿，需频繁更换敷料并触碰创面，增加患者痛苦和医护人员工作量。……