湿润烧伤膏治疗急性坏死性筋膜炎手术创面的疗效分析(1)
[摘要] 目的 探讨湿润烧伤膏(MEBO)对急性坏死性筋膜炎术后创面的治疗效果。方法 方便选取2010年1月—2017年6月江苏省盐城正大医院和盐城市第一人民医院普外科收治的20例急性坏死性筋膜炎患者，随机分为MEBO组(10例)和常规组(10例)，在常规术后全身治疗的基础上，MEBO组患者切口创面生理盐水冲洗后采用MEBO药纱填塞引流，常规组患者切口创面碘伏水冲洗后应用凡士林油砂布治疗，对比观察两组患者创面愈合时间及愈合效果。结果 治疗2个月后，MEBO组患者切口创面平均愈合时间、术后平均住院时间均明显短于常规组，差异有统计学意义(t=8.813，10.163，P<0.05)。MEBO组患者创面愈后瘢痕形成例数1例，常规组4例，但差异无统计学意义(P>0.05)。结论 MEBO可促进创面组织再生修复，缩短创面愈合时间，疗效显著，是治疗坏死性筋膜炎的有效方法。
[关键词] 湿润烧伤膏；急性坏死性筋膜炎；治疗效果
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)01(b)-0131-03
[Abstract] Objective To study the effect of moist exposed burn ointment in treatment of operative wound surface of acute necrotizing fasciitis. Methods 20 cases of patients with acute necrotizing fasciitis admitted and treated in our hospital from January 2010 to June 2017 were convenient selected and randomly divided into two groups with 10 casesin each， both groups adopted the general treatment after the routine surgery， the MEBO group adopted the MEBO obturation and drainage after the washing of wound surface normal saline， and the routine group were treated with vaseline after the washing of incision wound iodine， and the wound healing time and healing effect were compared between the two groups. Results After two-month treatment， the average healing time of incision wound surface， and average length of stay after surgery in the MEBO group were obviously shorter than those in the routine group， and the differences were statistically significant(t=8.813， 10.163， P<0.05)， and the cicatrization case after the wound surface healing in the MEBO group and in the routine group was respectively 1 and 4， but the difference was not statistically significant(P>0.05). Conclusion The MEBO can promote the regeneration of wound surface tissues and shorten the wound surface healing time， and the curative effect is obvious， and it is an effective treatment method of necrotizing fasciitis.
[Key words] Moist exposed burn ointment； Acute necrotizing fasciitis； Treatment effect
急性壞死性筋膜炎又称Fournier’s坏疽，是细菌入侵皮肤组织，沿浅筋膜层快速、潜行蔓延，致使皮下组织及浅筋膜进行性水肿、坏死并伴有全身严重中毒症状的急性坏死性感染，局部典型表现为红、肿、热、痛，突出表现为“硬”，可形成张力性水疱，局部体征和全身症状不相称是本病的主要特征[1]。该病发病急、进展快、病情重， 常伴有脓毒性休克及多器官功能衰竭，若不能及时诊断， 单纯抗感染治疗常导致患者死亡，病死率高达30%以上[2-3]。该院从2010年1月—2017年6月应用湿润烧伤膏(moist exposed burn ointment，MEBO)治疗急性坏死性筋膜炎10例患者，效果满意，现报道如下。
1 资料与方法
1.1 一般资料
方便选取2010年1月—2017年6月江苏省盐城正大医院和盐城市第一人民医院普外科收治的20例急性坏死性筋膜炎患者，其中男性11例，女性9例，年龄35～75岁，所有患者均超出正常体重，无明显原发病灶，入院时脓肿局部红肿，皮温偏高，有12例患者出现不同程度的发热，脓肿范围最小约2.0 cm×3.0 cm，最大约5.0 cm×4.0 cm；脓肿位于会阴部者13例，臀部4例，大腿者2例，腹壁者1例。按照随机数字表法，将该组患者随机分为MEBO组(10例)与常规组(10例)，两组患者的年龄、性别、BMI(体重指数)及基础病等临床资料均具有可比性，差异无统计学意义(P>0.05)。见表1，表2。, http://www.100md.com(李作宝 李作安 路九昌 陆寿耆)
[关键词] 湿润烧伤膏；急性坏死性筋膜炎；治疗效果
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)01(b)-0131-03
[Abstract] Objective To study the effect of moist exposed burn ointment in treatment of operative wound surface of acute necrotizing fasciitis. Methods 20 cases of patients with acute necrotizing fasciitis admitted and treated in our hospital from January 2010 to June 2017 were convenient selected and randomly divided into two groups with 10 casesin each， both groups adopted the general treatment after the routine surgery， the MEBO group adopted the MEBO obturation and drainage after the washing of wound surface normal saline， and the routine group were treated with vaseline after the washing of incision wound iodine， and the wound healing time and healing effect were compared between the two groups. Results After two-month treatment， the average healing time of incision wound surface， and average length of stay after surgery in the MEBO group were obviously shorter than those in the routine group， and the differences were statistically significant(t=8.813， 10.163， P<0.05)， and the cicatrization case after the wound surface healing in the MEBO group and in the routine group was respectively 1 and 4， but the difference was not statistically significant(P>0.05). Conclusion The MEBO can promote the regeneration of wound surface tissues and shorten the wound surface healing time， and the curative effect is obvious， and it is an effective treatment method of necrotizing fasciitis.
[Key words] Moist exposed burn ointment； Acute necrotizing fasciitis； Treatment effect
急性壞死性筋膜炎又称Fournier’s坏疽，是细菌入侵皮肤组织，沿浅筋膜层快速、潜行蔓延，致使皮下组织及浅筋膜进行性水肿、坏死并伴有全身严重中毒症状的急性坏死性感染，局部典型表现为红、肿、热、痛，突出表现为“硬”，可形成张力性水疱，局部体征和全身症状不相称是本病的主要特征[1]。该病发病急、进展快、病情重， 常伴有脓毒性休克及多器官功能衰竭，若不能及时诊断， 单纯抗感染治疗常导致患者死亡，病死率高达30%以上[2-3]。该院从2010年1月—2017年6月应用湿润烧伤膏(moist exposed burn ointment，MEBO)治疗急性坏死性筋膜炎10例患者，效果满意，现报道如下。
1 资料与方法
1.1 一般资料
方便选取2010年1月—2017年6月江苏省盐城正大医院和盐城市第一人民医院普外科收治的20例急性坏死性筋膜炎患者，其中男性11例，女性9例，年龄35～75岁，所有患者均超出正常体重，无明显原发病灶，入院时脓肿局部红肿，皮温偏高，有12例患者出现不同程度的发热，脓肿范围最小约2.0 cm×3.0 cm，最大约5.0 cm×4.0 cm；脓肿位于会阴部者13例，臀部4例，大腿者2例，腹壁者1例。按照随机数字表法，将该组患者随机分为MEBO组(10例)与常规组(10例)，两组患者的年龄、性别、BMI(体重指数)及基础病等临床资料均具有可比性，差异无统计学意义(P>0.05)。见表1，表2。, http://www.100md.com(李作宝 李作安 路九昌 陆寿耆)