不同皮肤移植方法在大面积烧伤瘢痕修复中效果比较.docVIP

不同皮肤移植方法在大面积烧伤瘢痕修复中的效果比较 　　[摘要]目的：探讨复合皮移植术与反复切取后躯干瘢痕皮修复对大面积烧伤瘢痕整形患者免疫耐受、创面愈合情况的影响。方法：选取于本院烧伤科就诊或住院治疗的96例大面积烧伤瘢痕整形患者，按照随机数字表法分为2组，对照组46例患者采用反复切取后躯干瘢痕皮方法进行治疗，观察组50例患者采取复合皮移植术治疗，比较两组患者治疗后血管紧张素Ⅱ（AngⅡ）及CD46水平、创面愈合率、创面周围炎症反应情况。结果：治疗后两组患者血清AngⅡ、CD46水平与治疗前相比均下降（P0.05），观察组下降较对照组更为明显，组间比较差异有统计学意义（P0.05）；观察组患者治疗后14d、21d、28d、35d创面愈合率及创面周围炎症反应评分均高于对照组，差异有统计学意义（P0.05）；与对照组相比，观察组患者平均创面愈合时间及创面皮肤血运恢复时间更短，术后并发症发生率更低（P0.05）。结论：复合皮移植术与常规皮肤移植方法相比能够降低大面积烧伤瘢痕整形患者皮肤移植后的排异反应，加速创面愈合并减少术后并发症，值得临床推广应用。 　　[关键词]复合皮移植术；大面积烧伤；瘢痕修复；CD46；创面愈合 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2018）03-0036-03 　　Comparison of the Effect of Different Skin Grafting Methods in Scar Repair of Large Area Burns 　　DING Wei-jia，CHEN Yin，ZHENG Wei-ji，HE Mu 　　（Department of Burn Surgery，Longgang Central Hospital of Shenzhen，Shenzhen 518116，Guangdong，China） 　　Abstract： Objective To investigate the effects of skin grafting combined with skin grafting on the immune tolerance and wound healing in patients with scar burn and plastic surgery. Methods 96 cases of patients with large-scale burn scar-shaped were selected in this study. All patients were randomly divided into two groups.46 patients in the control group were treated by repeatedly taking the scar skin after torso treatment， and 50 patients in the observation group were treated with compound skin grafts. The serum level of angiotensin Ⅱ （Ang Ⅱ）， serum level of CD46， wound healing rate and inflammation around the wound were compared between two groups after treatment. Results After treatment， the serum level of Ang Ⅱ and CD46 in both groups were decreased（P0.05）， and the observation group was more obvious than the control group（P0.05）. The wound healing rate and inflammation response score around the wound of 14d， 21d， 28d， 35d in the observation group were higher than those of the control group， and the difference was statistically significant（P0.05）. Compared with the control group， the average wound healing time and the wound skin blood transport recovery tim