[1]李文生,徐银兰,武延朋,等.脱细胞异体真皮与自体瘢痕组织联合自体刃厚皮复合移植修复大面积烧伤后畸形的疗效比较[J].新乡医学院学报,2019,36(12):1175-1178.[doi:10.7683/xxyxyxb.2019.12.018]
　LI Wen-sheng,XU Yin-lan,WU Yan-peng,et al.Comparative effectiveness of acellular allogeneic dermis and autologous scar tissue combined with autologous blast-thickened skin combined transplantation to repair the malformations after extensive burn[J].Journal of Xinxiang Medical University,2019,36(12):1175-1178.[doi:10.7683/xxyxyxb.2019.12.018]
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脱细胞异体真皮与自体瘢痕组织联合自体刃厚皮复合移植修复大面积烧伤后畸形的疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年12
页码:
1175-1178
栏目:
临床研究
出版日期:
2019-12-12

文章信息/Info

Title:
Comparative effectiveness of acellular allogeneic dermis and autologous scar tissue combined with autologous blast-thickened skin combined transplantation to repair the malformations after extensive burn
作者:
李文生1; 徐银兰2; 武延朋1 ; 王瞾华1; 裴敬仲1; 钟　秋2; 万双秀2
（1.新乡市第二人民医院烧伤一科，河南　新乡　453000；2.山西农业大学动物科技学院，山西　太谷　030801）
Author(s):
LI Wen-sheng1; XU Yin-lan2; WU Yan-peng1; WANG Zhao-hua1; PEI Jing-zhong1; ZHONG Qiu2; WAN Shuang-xiu2
(1.Department of Burn,the Second People′s Hospital of Xinxiang City,Xinxiang 453000,Henan Province,China;2.College of Animal Science and Technology,Shanxi Agricultural University,Taigu 030801,Shanxi Province,China)
关键词:
大面积烧伤; 自体瘢痕组织; 自体刃厚皮; 脱细胞异体真皮
Keywords:
large area burn;  autologous scar tissue;  autologous split thickness skin;  acellular allogeneic dermis
分类号:
R622
DOI:
10.7683/xxyxyxb.2019.12.018
文献标志码:
A
摘要:
目的　比较脱细胞异体真皮与自体瘢痕组织联合自体刃厚皮复合移植修复大面积烧伤后畸形的临床疗效。方法　选择2010年1月至2015年6月新乡市第二人民医院收治的26例大面积烧伤后畸形患者为研究对象。按照移植修复方案将患者分为脱细胞异体真皮联合自体刃厚皮复合移植组（A组，n=12）和自体瘢痕组织联合自体刃厚皮复合移植组（B组，n=14）。术后3、6个月，观察2组患者创面愈合率、创面收缩率，采用温哥华瘢痕量表（VSS）评估创面修复情况；采用焦虑自评量表（SAS）及抑郁自评量表（SDS）评估2组患者术前及术后3、6个月心理状态。结果　2组患者术后6个月创面愈合率、创面收缩率高于术后3个月（P<0.05）。术后6个月，B组患者创面愈合率高于A组（P<0.05）， 2组患者创面收缩率比较差异无统计学意义（P>0.05）。术后6个月，2组患者创面血管分布、厚度、柔软度评分低于术后3个月（P<0.05）；2组患者创面色泽评分与术后3个月比较差异无统计学意义（P>0.05）。术后6个月，2组患者创面血管分布、厚度、柔软度、色泽评分比较差异无统计学意义（P>0.05）。术前，2组患者SAS、SDS评分比较差异无统计学意义（P>0.05）。术后3、6个月，2组患者SAS、SDS评分低于术前；且B组患者SAS、SDS评分低于A组（P<0.05）。A组和B组患者复合移植成活率分别为（91.0±2.1）%和（96.0±2.4）%；2组患者复合移植成活率比较差异无统计学意义（P>0.05）。结论　自体瘢痕组织联合自体刃厚皮复合移植方案修复大面积烧伤后畸形，整体修复效果好，创面愈合率高，患者心理负担低。
Abstract:
Objective　To compare the clinical effect of acellular allogeneic dermis and autologous scar tissue combined with autologous blast-thickened skin combined transplantation to repair the malformations after extensive burn.Methods　Twenty-six patients with severe post-burn deformities admitted to the Second People′s Hospital of Xinxiang City from January 2010 to June 2015 were selected as subjects.The patients were divided into acellular allogeneic dermis combined with autologous bladed skin composite transplantation group (group A, n=12) and autologous scar tissue combined with autologous bladed skin composite transplantation group (group B, n=14) according to the transplantation repair plan.At 3, 6 months after operation, the wound healing rate and the wound contraction rate were observed, the Vancouver scar scale was used to assess the condition of wound repair.The self-rating depression scale(SDS) and self-rating anxiety scale(SAS) were used to evaluate the psychological status of the patients in the two groups before operation and at 3,6 months after operation.Results　The wound healing rate and wound contraction of patients in the two groups at six months after operation were higher than those at three months after operation(P<0.05).The wound healing rate of patients in the group A was higher than that in the group B at six months after operation(P<0.05).There was no significant difference in the wound contraction rate between the two groups at six months after operation（P>0.05）.The scores of vascular distribution, thickness and softness in the two groups at six months after operation were lower than those at three months after operation(P<0.05).There was no significant difference in the color score of wound between that at six months after surgery and at three months after surgery in the two groups（P>0.05）.There was no significant difference in the score of vascular distribution, thickness,softness and color of wound between the two groups at six months after operation（P>0.05）. Before surgery, there was no significant difference in the scores of SAS and SDS between the two groups (P>0.05).The scores of SAS and SDS in the two groups at three and six months after operation were lower than those before operation（P<0.05）,and the scores of SAS and SDS in the group B were lower than those in the group A （P<0.05）.At six months after operation, the composite graft survival rate in the group A and group B was （91.0±2.1）% and （96.0±2.4）%,there was no significant difference in the composite graft survival rate between the two groups(P>0.05).Conclusion　Autologous scar tissue combined with autologous thick-skinned composite transplantation scheme to repair the patients with large post-burn malformed area is effective with good overall effect, high wound healing rate and low psychological burden.

参考文献/References:

［1］　林陆添，蔡少甫，叶严丽，等.脱细胞异体真皮与自体刃厚头皮复合移植治疗臀部瘢痕4例［J］.西南国防医药, 2011, 21(12): 1339-1340.
［2］　赵筱卓, 宁方刚, 杜伟力, 等.导入透明质酸的脱细胞羊皮联合自体微粒皮复合移植治疗大面积烧伤［J］.中华外科杂志, 2014, 52(4): 285-288.
［3］　岳丽青, 王晓燕, 彭欢, 等.手烧伤康复研究进展［J］.医学临床研究, 2014, 31(4): 816-819.
［4］　刘海兵, 唐丹, 曹海燕, 等.温哥华瘢痕量表的信度研究［J］.中国康复医学杂志, 2006, 21(3): 240-242.
［5］　段泉泉, 胜利.焦虑及抑郁自评量表的临床效度［J］.中国心理卫生杂志, 2012, 26(9): 676-679.
［6］　李春江, 於国军, 孙勇, 等.脱细胞异体真皮与自体薄皮片复合移植在老年烧伤整形患者中的应用［J］.中国老年学杂志, 2012, 32(2): 386-387.
［7］　李武全, 邱啸臣, 刘军, 等.大面积烧伤微粒皮移植应用脱细胞猪皮与异体皮作为覆盖物的对比研究［J］.第二军医大学学报, 2012, 33(11): 1207-1211.
［8］　余勇, 赵慧, 许瑾, 等.脱细 胞异体真皮支架与自体皮片复合移植的临床应用［J］.蚌埠医学院学报, 2012, 37(10): 1189-1190.
［9］　梁拥军, 眭怀清, 赵建华, 等.复合移植修复深度烧伤创面临床疗效观察［J］.中国药物与临床, 2013，13（6）：780-782.
［10］　左海斌, 彭代智, 郑必祥, 等.异体颗粒状脱细胞真皮基质与自体刃厚皮复合移植修复大鼠皮肤缺损创面效果观察［J］.中华烧伤杂志, 2011, 27(1): 10-15.
［11］　贺斌, 戴永恒, 钱利，等.深度烧伤创面异体脱细胞真皮基质与自体刃厚皮复合移植的临床观察［J］.现代生物医学进展, 2011, 11(13): 2432-2434.
［12］　杨建民, 王配合, 李建全, 等.脱细胞异体真皮和自体刃厚皮复合移植在功能部位深度烧伤中的应用［J］.解放军医药杂志, 2014, 26(5): 45-47.
［13］　张春华, 李慧, 王峻岭, 等.不同植皮方式在重度关节烧伤中的修复效果及其对微循环的影响［J］.西部医学, 2014, 26(8): 996-998.
［14］　黄勇, 徐盈斌, 张旭辉, 等.不同比例自体微粒皮与异体脱细胞微粒真皮复合移植的研究［J］.中华实验外科杂志, 2011, 28(9): 1441-1444.
［15］　栾芳.烧伤变形脱细胞真皮基质用于烧伤创面修复的可行性研究［J］.安徽医药, 2016, 20(6): 1123-1126.

更新日期/Last Update: 2019-12-05