肝素应用于深Ⅱ度烧伤创面临床观察.docVIP

肝素应用于深Ⅱ度烧伤创面临床观察[摘要]目的：探讨肝素对深Ⅱ度烧伤创面的治疗效果。方法：伤后24h入院的烧伤患者30例， 3%～50% 烧伤面积，以深Ⅱ度为主，清创后实验区先用肝素钠湿敷，再用磺胺嘧啶银乳膏包扎，对照区应用磺胺嘧啶银乳膏包扎，每日1次，3天后改为半暴露。观察创面疼痛缓解、水肿消退、愈合时间等。结果：实验区创面肝素湿敷数分钟后疼痛明显减轻，水肿消退快，愈合时间明显少于对照区。结论：肝素直接外用于深Ⅱ度烧伤创面能缓解疼痛，缩短愈合时间。 [关键词]烧伤;肝素;创面愈合 [中图分类号]R644[文献标识码]A[文章编号]1008-6455（2008）03-02 Clinical observation of the effect of heparin on deep partial thickness burn wound LI Yan1, HUO Ran1, KONG Xiang-hong1, ZHANG Zhi-hua2, ZHOU Li-ping2, ZHANG Hong-tu2 (1.Department of Burns and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021，Shandong, China；2. Department of Burns and Plastic Surgery, Jining First People’s Hospital, Jining 272100,Shandong, China） Abstract:ObjectiveTo investigate the effects of heparin on deep partial thickness burn wound. Methods Thirty cases inflicted with 3%～50% TBSA deep partial thickness burn wound, after fresh wound was debrided, the treating area was handled with heparin and Sulfadiazine silver cream, while the control area was treated with Sulfadiazine silver cream, until the wound healing. Reliving pain and the wound healing time were observed simultaneously.ResultsPains were relieved after the wound handled with heparin; the wound healing time was much shorter in Heparin area than in SD-Ag area(P＜0.05).ConclusionIt is suggested that topical application of heparin to deep partial thickness burn wound may alleviate the progressive tissue damage, relive pain during early stage and promote wound healing. Key words：burn; heparin; wound healing 肝素作为氨基聚糖（Glycosaminoglycans, GAGS）的一种，最初被应用于抗凝，后越来越多的功能被发现,并应用于烧伤创面[1]。目前，国内主要是进行一些动物实验研究，临床应用很少。笔者采用外用肝素治疗深Ⅱ度烧伤创面，旨在观察对创面疼痛缓解，愈合及并发症的影响。 1资料和方法 1.1 一般资料：伤后24h内入院，烧伤面积（TBSA）3%～50%，以深Ⅱ度或深Ⅱ度为主患者30例，男24例，女6例，年龄16～45岁。选择患者烧伤面积约10cm×10cm，相邻或对称部位的2个创面，进行同体对照。用体积分数0.1%的苯扎溴铵清洗创面，去除腐皮，碘伏消毒，治疗区用肝素钠（天津市生物化学制药厂，规格为12 500U/支）2支，湿敷于创面，再用磺胺嘧啶银乳膏（山东健康药业有限公司，规格为体积分数1%）包扎。对照区仅用磺胺嘧啶银乳膏包扎，每日1次，3天后依据创面渗出情况改为半暴露或继续包扎，直至愈合。患者依全身情况和烧伤面积给予相应的全身治疗。 1.2 观察指