断层浅筋膜创面皮肤移植术治疗大面积Ⅲ度烧伤临床研究.docVIP

断层浅筋膜创面皮肤移植术治疗大面积Ⅲ度烧伤临床研究 　　[摘要] 目的 研究分析大面积III度烧伤患者接受断层浅筋膜创面皮肤移植手术治疗的临床效果。 方法 根据该院2010年5月―2013年5月的35例烧伤患者和2011年6月―2014年5月的32例烧伤患者来进行分析，前者作为对照组使用深筋膜创面皮肤移植术进行治疗，后者作为观察组，使用改进后的断层浅筋膜创面皮肤移植术进行治疗，对两组的患者手术情况进行对比分析。 结果 观察组患者和对照组患者的手术时间、植皮成活率、创面愈合时间等等对比差异无统计学意义（P0.05）；观察组患者接受治疗后，上下肢瘢痕面积分别缩小5.5%和5.7%，对照组为22.1%和24.8%，两组结果差异具有统计学意义（P0.05）。 结论 大面积III度烧伤患者接受断层浅筋膜创面皮肤移植术治疗的临床效果突出，患者的瘢痕显著淡化，愈合质量高，功能部位经过治疗得到了比较好的恢复，临床中应用价值非常高。 　　[Abstract] Objective To research and analyze the clinical effect of fault fibroareolar fascia wound skin grafting in treatment of patients with large Ⅲ degree burn. Methods 35 cases of patients with burns treated in our hospital from May 2003 to May 2006 and 32 cases of patients with burns treated from June 2006 to May 2010 were selected， the control group were treated with fault fibroareolar fascia wound skin grafting， the observation group were treated with improved fault fibroareolar fascia wound skin grafting， the operation condition of the two groups was compared and analyzed. Results There was no statistical difference in the operation time， skin graft survival rate and wound healing time between the two groups，（P0.05），after treatment， the self-ratio of upper and lower limbs narrowed by 5.5% and 5.7% in the observation group and 22.1% and 24.8% in the control group， there was a statistical difference between the two results， （P0.05）. Conclusion The clinical effect of fault fibroareolar fascia wound skin grafting in treatment of large Ⅲ degree burn is prominent， the scar of the patients is obviously desalted， and the healing quality is high， the function parts get a better recovery after treatment， and it is of high clinical application value. 　　[Key words] Burn； Fibroareolar fascia； Skin grafting 　　大面积III度烧伤患者接受传统的手术治疗方式是使用深筋膜创面皮肤移植术，大面积III度烧伤患者其皮肤全层都已经受到了损伤，患者急需接受植皮手术治疗，对创面封闭治疗，烧伤后患者的脂肪层血运情况不佳，如果保留脂肪层，会影响植皮的血运情况，导致其供血和营养不足，植皮部分无法存活，所以通常手术时，要将患者植皮部位的脂肪层全部切除，进行血运丰富的深筋膜浅层植皮手术，也就是深筋膜创面皮肤移植术。该种手术使用时需要将患者的坏死组织切除，而且正常脂肪组织也需要切除，患者的组织受损情况比较严重，术后愈合情况不佳，愈合部