韩旭 孟蕴芳 梁艳

[摘要]目的：探討Meek植皮术联合综合性康复护理干预对烧伤患者创面愈合及安全性的影响。方法：选取2018年1月-2019年12月笔者医院外科收治的202例烧伤患者作为研究对象，按随机数字表法将其分为对照组（n=101）和观察组（n=101）。对照组给予邮票植皮术治疗，观察组给予Meek植皮术治疗，两组治疗期间均辅助综合性康复护理进行干预，均干预2个月。比较两组干预2个月后的美容效果及创面恢复情况，干预前、干预2个月后的温哥华瘢痕量表（Vancouver scar scale，VSS）评分及瘢痕美容评估与评级量表（Scar cosmesis assessment and rating，SCAR）评分;统计两组干预期间的并发症总发生率。结果：观察组美容效果优良率为90.10%，显著高于对照组的78.22%，差异有统计学意义（P<0.05）。观察组体温恢复正常时间、血小板计数恢复正常时间、创面愈合时间、创面皮肤血运恢复时间均显著短于对照组，差异有统计学意义（P<0.05）。与干预前比，干预2个月后，两组VSS评分、SCAR评分均降低，且观察组均显著低于对照组，差异有统计学意义（P<0.05）。观察组并发症总发生率为12.87%，显著低于对照组的30.69%，差异有统计学意义（P<0.05）。结论：Meek植皮术联合综合性康复护理干预，可明显改善烧伤患者瘢痕，促进患者创面愈合，疗效显著，且具有较高安全性。

[关键词]烧伤;Meek植皮术;邮票植皮术;综合性康复护理;瘢痕;创面愈合;安全性

[中图分类号]R644    [文献标志码]A    [文章编号]1008-6455（2021）06-0046-04

Effect of Meek Skin Grafting Combined with Comprehensive Rehabilitation Nursing Intervention on Wound Healing of Burn Patients

HAN Xu1，MENG Yun-fang2，LIANG Yan2

（1.Physical Examination Center;2.Department of Burn，Chaoyang Central Hospital，Chaoyang 122000，Liaoning，China）

Abstract： Objective  To investigate the effect of Meek skin grafting combined with comprehensive rehabilitation nursing intervention on wound healing and safety of burn patients. Methods  A total of 202 burn patients admitted in our hospital between January 2018 and December 2019 were selected as the research object， and they were divided into the control group （n=101） and the observation group （n=101） according to the random number table method. The control group was given stamp skin grafting treatment， and the observation group was given Meek skin grafting treatment. Both groups were assisted by comprehensive rehabilitation nursing intervention during the treatment period， both interventions were for 2 months. The cosmetic effect and wound recovery of the two groups after 2 months of intervention， the scores of Vancouver scar scale （VSS） and the Scar cosmesis assessment and rating （SCAR） before and after 2 months of intervention were compared. The two groups of interventions the total incidence of complications during the period were counted. Results  The excellent rate of beauty effect in the observation group was 90.10%， significantly higher than that in the control group（78.22%）， the difference was statistically significant （P<0.05）. The time of normal temperature recovery， platelet count normal time recovery， wound healing time， and wound skin blood flow recovery time in the observation group were significantly shorter than those in the control group （P<0.05）. Compared with before intervention， after 2 months of intervention， the scores of VSS and SCAR in both groups decreased， and the observation group were significantly lower than the control group （P<0.05）. The total incidence of complications in the observation group was 12.87%， significantly lower than that in the control group （30.69%， P<0.05）. Conclusion  Meek skin graft grafting combined with comprehensive rehabilitation nursing intervention can significantly improve the scars of burn patients， promote the healing of patients' wounds， have a significant effect and has high security.

Key words： burn; Meek skin grafting; stamp skin grafting; comprehensive rehabilitation nursing; scar; wound healing; safety

烧伤是指由蒸汽、高温气体、热液（水、油）等引起的皮肤、黏膜组织损伤[1]，患者一但被烧伤，不仅造成毁容，还易导致皮肤渗出液增多，血液循环下降，严重影响患者外观形象及身体健康[2]。目前，烧伤患者多采用烧伤植皮手术进行治疗，包括邮票植皮术、Meek植皮术等，其中邮票植皮术在应用过程中具有植皮成活率高的特点，但该手术扩张比例有限，因此，在大面積烧伤患者中应用有限[3]。Meek植皮术在治疗烧伤患者的过程中可充分利用患者有效正常皮肤组织，更好地修复患者创伤部位，但对大面积烧伤患者是否有效尚需研究[4]。研究[5]表明，在治疗的同时辅以相应护理措施，可进一步提高疗效，其中综合性康复护理方案具有整体性，可充分考虑患者自身情况，对患者进行有针对性的护理。……