| 肖宜敏.MEBO治疗慢性难愈性皮肤溃疡的临床疗效观察[J].中国烧伤创疡杂志,2015,(6):410~414. |
| DOI： |
| 中文关键词: 慢性溃疡 难愈性溃疡 湿润烧伤膏 药刀结合 疗效 |
| 英文关键词:Chronic ulcer Refractory ulcer MEBO Medication plus surgical operation Efficacy |
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| 中文摘要: |
| 目的 观察湿润烧伤膏(Moist Exposed Burn Ointment, MEBO) 治疗慢性难愈性皮肤溃疡的临床疗效? 方法 对2010年1月-2014年12月收治的344例慢性难愈性皮肤溃疡患者创面采用“药刀结合” 的方法治疗, 药即MEBO, 刀即外科清创术?植皮术等?患者初诊时尽量清除创面坏死组织, 不能耐受一次性清创者行蚕食疗法；清创后创面均匀涂抹MEBO并外敷MEBO药纱包扎治疗, 存在潜腔的创面用MEBO 药纱填塞引流,待肉芽组织填满创面后行肉芽创面游离植皮术?观察患者创面愈合时间及愈合情况? 结果 344例患者中除38例患者好转后自动出院, 3例患者死于基础疾病外,其余303例患者创面均完全愈合,愈合率达88.1%, 创面平均愈合时间为80.4d±15.8d?其中, 193 例患者经MEBO 换药治疗后创面自行愈合(56.1%)；48例合并趾骨坏死的糖尿病足患者进行了坏死组织剜除术(14.0%)；34例骨外露创面进行了钻孔(9.9%)；54例患者进行了肉芽创面植皮术(包括接受趾骨剜除术及骨钻孔术后的创面)?89例烧伤残余创面愈合较快, 最短为7d,最长为29d, 平均愈合时间为18.8 d ±4.9d? 结论 MEBO可有效控制创面感染, 促进坏死组织液化脱落及肉芽组织生长, 缩短创面愈合时间, 减轻患者疼痛, 适时配合“刀法” 还可进一步加速坏死组织脱落, 促进肉芽组织生长, 及时封闭创面, 减少瘢痕增生, 是治疗慢性难愈性皮肤溃疡的理想方法。 |
| 英文摘要: |
| Objective To observe the clinical efficacy of Moist Exposed Burn Ointment (MEBO) in treating chronic refractory skin ulcer. Methods A total of 344 patients with chronic refractory skin ulcer admitted between January 2010 and December 2014 were treated with the protocol of MEBO application plus surgical operations (debridement, skin graft and etc.). Necrotic tissues were removed as much as possible during the first visit. For patients can’t tolerate one time debridement, encroaching debridement should be carried out. After the debridement, MEBO was smeared onto the wounds evenly and then the wounds were bandaged after MEBO impregnated gauze was covered. For wounds with hidden cavities, fill the cavities with MEBO impregnated gauzes for drainage, and free skin grafting was performed when the wound was filled with granulation tissues. The wound healing time and healing condition were observed. Results Among the 344 patients, 38 patients discharged from the hospital voluntarily when the disease turned better, 3 patients died of underlying diseases and the other 303 patients realized complete wound healing, with a healing rate being 88.1% and mean wound healing time being 80.44 d±15.83 d. Of the 303 patients, 193 patients (56.1%) realized wound automatic healing after MEBO dressing change, 48 patients (14.0%) with diabetic foot plus phalanx necrosis were given enucleation of necrotic tissues, 34 patients (9.9%) with bone exposure were given drilling operation. A total of 54 patients were given skin grafting in wound granulation tissues (including patients undergoing phalanx enucleation and drilling operation). 89 patients with burn residual wounds realized faster healing, with the shortest healing time of 7 days, the longest 29 days and the mean 18.8d±4.9d. Conclusion MEBO can effectively control wound infection, promote liquefaction and remove of necrotic tissues, speed up the growth of granulation tissues, shorten wound healing time, alleviate patients’ pain. The detachment of necrotic tissues, the growth of granulation tissues, the healing time of wound as well as the formation of hyperplasic scar all can be improved if suitable surgical operations were timely adopted together, which is an ideal treatment protocol for chronic refractory skin ulcer. |
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