目的 观察改性甲壳素创面修复凝露联合红光照射治疗慢性皮肤溃疡的临床效果.方法 选取2013年10月至2014年10月本院收治的104例慢性皮肤溃疡患者为研究对象,将其随机分为对照组(51例)与观察组(53例).对照组患者采用常规治疗,观察组患者采用改性甲壳素创面修复凝露联合红光照射治疗,两组疗程均为30天.观察并评价两组患者的治疗效果及溃疡愈合时间.结果 治疗后,观察组总有效率(96.2％)明显高于对照组(85.3％)(P＜0.05),观察组患者溃疡愈合时间[(14.4±2.1)天]显著短于对照组[(21.4±2.4)天](P＜0.05).结论 改性甲壳素创面修复凝露联合红光照射治疗慢性皮肤溃疡的临床效果明显优于用常规治疗.

Objective To explore the clinical significance of serum hyaluronic acid detection in patients with psoriasis. Method Randomly selected from November 2013 to November 2014, 144 cases of patients with psoriasis as experimental group, selected 126 healthy adults as control group. All research objects adopted radioimmunoassay to measure the serum hyaluronic acid concentration, compared the serum hyaluronic acid concentration of patients with psoriasis and healthy adults and serum hyaluronic acid concentration in patients with psoriasis vulgaris and specific types of psoriasis. Result Serum hyaluronic acid concentration of experimental group patients was higher than that of control group, there was statistical difference between the two groups (P<0.05). Serum hyaluronic acid concentration in patients with psoriasis vulgaris and speciifc types of psoriasis, was not statistically signiifcant difference (P > 0.05). Conclusion Serum hyaluronic acid concentration detection can be used to diagnose psoriasis, but it is inapplicability to identify the type of psoriasis.

Objective To investigate the clinical therapeutic effect of the vacuum-sealing drainage (VSD) combining with skin graft in a deep burn wound.Methods Sixty one patients were divided into two groups according to treatment method.Thirty tree patients were assigned as the VSD treatment group,which was treated by VSD after debridement; their wounds were transplanted by the split thickness skins binding up by VSD when they were fitted.Twenty eight patients were assigned as the routine treatment group,which was treated by means of traditional regular dressing change to remove necrotic tissue and promote granulation tissue; their wounds were transplanted by the split thickness skins binding up by packing when they were fitted.Results After treatment by VSD,there are no systemic hypersensitivity reactions and abnormal bleeding.Thirty three cases of VSD treatment group were treated by VSD for 7 ～ 10 days,the other 2 cases were treated by VSD for another 7 ～ 10 days because of granulation tissue badly.Until their granulation was fresh,skin grafting technique was used and the skin survived well.The treatment time before skin grafts,the pain score,and the cost of ablative therapy for wound were ( 8 ± 0.9) day,(5.7 ± 1.6) point,and ( 1.5 ± 0.4) ten thousand yuan in VSD group vs.( 14 ± 1.2) day,(3.1 ± 1.1 ) point,and (0.6± 0.2)ten thousand yuan in control group.The survival rate and the wound germiculture positive rate were 97.0％ and 6.5％ in the VSD group vs 75.0％ and 28.6％ in the control group.The differences between groups were statistically significant ( P ＜ 0.05 ).Conclusions VSD is a simple method that is easy to grasp,and that can promote granulation tissue growth,reduces the wound germiculture positive rate,shortens the wound healing period,increases the survival rate of skin grafts,and relieves patients 'pain.It is worth popularizing and applying in the deep burn wound therapy.

目的探讨应用复方五味大黄酊剂对小型猪烧伤创面愈合的作用。方法选择20只中国实验用小型猪制作成深Ⅱ°烧伤动物模型,随机分成实验组和对照组,按伤后24h、3d、6d、9d、12d大体及组织细胞学切片观察,评价各组治疗效果。结果伤后9d实验组较对照组创面面积明显缩小(P<0.01),伤后12d实验组和对照组间差异无显著意义(P>0.05);伤后9d组织学检查实验组创面已被新生表皮覆盖,伤后12d实验组和对照组均被表皮覆盖,实验组表皮生长好于对照组。结论复方五味大黄酊剂是一种有效的治疗烧伤外用制剂,具有抗感染、减少渗出、迅速成膜的作用。

2003～2007年,我们采用自行研制的复方五味大黄酊治疗烧伤1 200例,疗效较好.现报告如下. 临床资料:本组1 200例患者中,男832例,女368例;年龄2～62岁.其中浅Ⅱ度烧伤915例,深Ⅱ度烧伤285例.烧伤面积占体表面积的5%～72%.致伤原因分别为火焰烧伤、热液烫伤、化学烧伤、电弧烧伤、放射线烧伤.

目的观察应用中草药浸浴烧伤患者康复期微循环的变化。监测其对烧伤后期康复治疗、功能恢复、创面修复、改善微循环的治疗效果。方法采用WX-753B型微循环显微镜及图像处理系统进行观测,应用法国产REF1254型自动调温浴缸。对50例烧伤康复期患者应用中草药浸浴,使其渗出和渗血减少,血流速度加快(P<0.01)。结果浸浴前烧伤康复期患者的足甲襞微循环最显著的变化管襻畸形率高(P<0.01),汗腺导管增多(P<0.01),血管管襻周围渗出等。浸浴前与治疗组比较经过中草药浸浴的烧伤病人足甲襞微循环血管管襻畸形明显改善,管襻周围的渗出、渗血减少。结论虽然严重烧伤经治疗伤面愈合,但是烧伤后微循环的紊乱长期存在,影响病人的康复。中草药浸浴可直接作用于全身治疗,一定时间内发挥药物作用,迅速改善微循环。具有时间短、作用快、效果显著的独特作用,最适合烧伤康复期病人的治疗。浸浴、浸浴前后进行足甲襞微循环襻动态观测,患者本组既往平均烧伤面积为(54.59±17.30)%,平均年龄为17～45岁,伤面愈合时间1～6个月。

目的:烧伤康复期患者应用中草药浸浴观察微循环的变化,对烧伤后期康复治疗是一种有效的治疗方法和监测手段.方法:采用WX-753B型微循环显微镜及图像处理系统进行观测,应用法国产REF1254型自动调温浴缸.观测烧伤康复期患者应用中草药浸浴足甲襞微循环及未经中草药浸浴的烧伤康复期患者的足甲襞微循环.结果:未经中草药浸浴烧伤康复期患者的足甲襞微循环与经过中草药浸浴的烧伤康复期病人足甲襞微循环比较,最显著的变化:管襻畸形率高(P<0.01),汗腺导管增多(P<0.01),血管管襻周围渗出等.结论:严重烧伤经治疗伤面愈合,但是烧伤后微循环的紊乱长期存在,影响病人的康复.经中草药浸浴治疗可明显改善烧伤康复期患者的微循环,适合烧伤康复期病人的治疗.

40例康复期烧伤患者,均予中草药(中药组方为荆芥、双花、野菊花、大黄、水蛭)浸浴。用微循环显微镜及图像处理系统观测其足甲襞微血管循环变化结果患者足甲襞微循环血管管襻畸形明显改善,管襻周围的渗出、渗血减少。认为用本方浸浴可迅速改善烧伤患者微循环,是烧伤患者康复治疗的有益补充。

Aim: To explore the practicability of repair of full skin loss of swine with composite artificial skin. Methods: Sixteen swines were grafted 3 surface of wound from full thickness skin to deep fascia on the back. The 3 surfaces were divided into compound skin grafting group and razor-thin grafts group(control Group 1) and full skin grafting group(control Group 2), respectively. The wound healing conditions were observed regularly after operation. Simultaneously, wound tissue samples were harvested for histological examination. Results: The artificial skin was composed of dermis and epidermis under light microscope. The epidermic cells proliferated, differenciated and developed into basal cell layer, prickle cell layer, granular layer and cuticula during healing. Conclusion: Composite skin, combined by epidermic cell suspension and acelluar dermal matrix, has double-deck structure of dermis and epidermis, so its histological form and ultrastructure are similar to skin. The source of skin can be increased by cultivation of epidermic cell, which can be provided for patients of large area deep burn. Tissue engineering skin equivalent has potential prospects in application of repairing skin defect.