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Clinical observation in treating skin pruritus of healed burns with MEBO Scareducer Lotion

Cheng-cun , LIANG  Xiu -qin ,CHEN Guang,Affiliated Hospital,Taishan Medical College ,Taian, Shangdong Province, 271000, China.

【Abstract】

Objective: To observe the efficacy of MEBO scar Lotion in treating skin prurits of healed deep Ⅱ°deep burns. 

Method: In a period of Jan. 2001- Oct. 2005, 206 cases of skin pruritus of healed deep Ⅱ°deep burns  were treated with MEBO scar Lotion. 

Results: In 206 cases, most of skin pruritus were cured after 6 weeks treatment. Effective power was 93.68%. Cure rate had been raised to 77.59%, although the cure rate in 3 weeks was only 15.53%. 

Conclusion: MEBO scar Lotion was effective in treating skin pruritus of healed deep Ⅱ0deep burns.

【Key words】MEBO scar lotion; Deep Ⅱ°deep burns; Skin pruritus

我科自2001年1月至2005年10月,使用美比欧疤痕平(北京美宝烧伤创疡研究所研制),治疗深Ⅱ度深型烧伤愈合后皮肤瘙痒症患者206例,取得了满意疗效。报告如下:

  一、资料与方法

  1.临床资料:206例均为住院患者。烧伤创面根据三度六分法诊断标准[1]进行诊断。所有患者住院期间应用烧伤再生医疗技术治疗。凡符合深Ⅱ度深型 烧伤,愈合后有瘙痒症状,并且伴有新生皮肤潮红、脱屑和弹性差的患者作为治疗对象。其中男性129例,女性77例;年龄2岁至57岁;深Ⅱ度深型烧伤面 积:最小3%TBSA、最大27%TBSA;热液烫伤89例、火焰烧伤76例、化学物质烧伤22例、电烧伤19例。

  2.治疗方法:用药前用温水清洁瘙痒区皮肤,纱布拭干后将美比欧疤痕平以擦手油方式涂于瘙痒区皮肤,以指腹轻压按摩5min~10min,每日用药4 次~6次。按摩时用力要轻,以防擦伤新生表皮组织,同时配合功能锻炼。首次评价治疗效果在用药后3周,除痊愈者外,其余患者继续用药治疗3周,然后作第二 次疗效评价。

  3.疗效判断标准:疗效分级:(1)痊愈:瘙痒症状消失,皮肤色泽正常,弹性良好;(2)显效:瘙痒症状消失,皮肤略潮红,弹性良好;(3)好转:瘙痒症状减轻,皮肤潮红,弹性一般;(4)无效:瘙痒无减轻,皮肤潮红,弹性差。

二、结果

206例患者治疗评价结果汇于表1。结果表明,美比欧疤痕平治疗深Ⅱ度深型烧伤愈合后皮肤瘙痒症有明显疗效,治疗3周后总有效率为77.66%。3周未愈的174例经过继续3周治疗,总有效率为93.68%。皮肤功能恢复好。206例患者用药期间均未发生毒副作用。

表1美比欧疤痕平疗效判定结果

组别

例数

痊愈(%

显效(%

好转(%

无效(%

总有效率(%

3周末

206

3215.53

12862.13

2713.11

199.22

77.66

6周末

174

13577.59

2816.09

95.17

21.15

93.68

表1显示:美比欧疤痕平治疗3周痊愈率仅占15.53%,而显效率为62.13%;治疗6周时,治愈率上升为77.59%,说明美比欧疤痕平的用药时间需延长至6周,方可产生理想的治疗效果。

三、讨论

  深Ⅱ度深型烧伤残存的真皮组织较少,且真皮组织的框架基本被破坏,应用再生医疗技术可以实现真皮组织的重建。重建过程包括:血管树的建立,纤维组织依 靠血管树的成形建立,皮肤潜能再生细胞的分化和增殖,最终形成表皮组织[1]。新生皮肤形成后,其结构、形态和功能与正常皮肤有很大的差别。由于真皮内微 血管功能不完善,周围神经末梢缺氧,再生的腺体组织紊乱失调,排泄管道未完全建立,修复期产生的纤维组织需要重构和调整,故新生皮肤在一段时间内有瘙痒、 潮红、干燥脱屑、弹性差等临床表现。由于患者搔抓、摩擦,可发生出血、感染,严重者形成小溃疡创面,容易诱发瘢痕形成。

  深Ⅱ度深型烧伤愈合皮肤的康复治疗,主要包括皮肤的保护性治疗和功能锻炼两个方面。传统疗法是用温生理盐水或用中药煎液浸浴新生皮肤,达到改善局部血 液循环、清洁皮肤的作用,配合功能锻炼,等待皮肤功能的自然恢复 ,该方法疗程长,患者痛苦大。自1995年以来,我们曾应用美宝止痒霜治疗,其止痒效果好,但是预防瘢痕的效果不理想。后来采取以擦手油方式涂用 MEBO,其润肤和防治瘢痕的效果较好[2],但止痒效果差。

美比欧疤痕平富含亚油酸、酪酸、芝麻素、仙人掌精等成分,可起到止痒、润肤的作用,能改善新生皮肤内微血管的功能和周围神经细胞的缺氧状态[3]。美比欧 疤痕平还能够调整新生皮肤的组织结构[1],对恢复皮肤弹性,预防和治疗瘢痕有良好疗效。本研究证明,美比欧疤痕平用于治疗深Ⅱ度深型烧伤愈合后皮肤瘙痒 症疗效显著。疤痕平 的治疗时间视病情而定。本研究表明,治疗3周并不能达到理想的效果,建议据病情延长治疗时间。


参考文献

[1]徐荣祥. 烧伤湿性医疗技术[J].中国烧伤创疡杂志,1997,(3):4-8.

[2]王广顺,等.湿性疗法对深Ⅱ度烧伤瘢痕防治的临床研究[J].中国烧伤创疡杂志,2001,13(4):246.

[3]徐荣祥. 美比欧疤痕平的护肤原理及使用说明[J]. 中国烧伤创疡杂志,1995,(1):封三、四.
 

【作者简介】

李承存(1968~),男(汉族),山东泰安人,泰山医学院毕业,科副主任,主治医师.
梁秀芹(1970~),女(汉族),山东泰安人,山东大学医学院毕业,护师.
陈光(1983~),男(汉族),山东泰安人,济宁医学院毕业,医师
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