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第六届全国创疡康复明星病例介绍(2)
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摘要:图1 入院时创面情况;图2-4 治疗过程中创面愈合情况;图5 治疗102 d后,创面基本愈合;图6 出院后4个月随访,愈后皮肤无明显瘫痕增生Fig. 1 The wound condi
图1 入院时创面情况;图2-4 治疗过程中创面愈合情况;图5 治疗102 d后,创面基本愈合;图6 出院后4个月随访,愈后皮肤无明显瘫痕增生Fig. 1 The wound condition on admission; Fig. 2-4 The wound condition during the treatment; Fig. 5 The wound was basically healed after 102 days of treatment; Fig. 6 No obvious scar hyperplasia was observed on the healed skin during the follow-up 4 months after discharge
病例6:患儿,女,2 d
患儿因双下肢先天性皮肤缺损于2015年10月2日入院治疗。专科检查:双侧大阴唇均可见面积约13.0 cm×13.0 cm的皮肤黏膜呈褐色,表面结痂,无液体渗出;双侧膝关节、胫前及足部可见总面积约11% TBSA的暗红色皮肤缺损创面呈对称性分布,形态不规则,边界清晰,无活动性出血,表层覆有透明薄膜样物质;左足拇趾及第2趾较正常足趾稍短,且无趾甲及甲床,右足拇趾及第2趾趾甲和甲床缺失。自患儿出生后第2天开始,创面规范应用湿润烧伤膏换药治疗。治疗18 d后,所有创面均完全愈合,左足拇趾及第2趾长度接近正常,但趾甲未长出;继续予以湿润烧伤膏护肤式治疗1周后,愈后皮肤逐渐由粉红色变为白色;疤痕软膏护肤式治疗30 d后,愈后皮肤颜色接近正常;疤痕软膏护肤式治疗18个月后,愈后皮肤无瘫痕增生及瘙痒等症状,部分皮肤留有少许色素脱失,皮肤痛温觉等感觉功能正常,双下肢生长发育正常,活动自如。(经治医院:太原市中铁十二局集团公司中心医院;经治医师:秦国强,丁明华)
图1 治疗前创面情况;图2-3 治疗过程中创面愈合情况;图4 治疗18 d后,创面完全愈合,左足拇趾及第2趾长度接近正常;图5-6 18个月后随访,愈后皮肤无瘫痕增生,部分皮肤留有少许色素脱失,双下肢生长发育正常Fig. 1 The wound condition before treatment; Fig. 2-3 The wound condition during the treatment; Fig. 4 The wound was completely healed after 18 days of treatment, and the lengths of left hallux and left second toe were basically at their normal lengths; Fig. 5-6 The follow-up of 18 months found no scar hyperplasia on the healed skin, little depigmentation on partial healed skin, and normal development of both lower limbs
病例7:宋某某,女,53岁
患者因右手被五步蛇咬伤致右手及右前臂出现瘀斑及血疱并逐渐破溃于2017年9月7日入院治疗。专科检查:右手及右前臂可见数个血疱,部分血疱破溃,有血红色液体流出。患者入院后,低位剪破血疱放出疱液后,创面全程规范应用湿润烧伤膏换药治疗。治疗54 d后,创面基本愈合,患者出院,并于家中自行应用湿润烧伤膏换药治疗。出院后随访9个月,创面愈合良好,愈后皮肤无明显瘫痕增生,上肢功能恢复。(经治医院:福建中医药大学附属人民医院;经治医师:王世军)
图1 入院时创面情况;图2-4 治疗过程中创面愈合情况;图5-6 出院后9个月随访,愈后皮肤无明显瘫痕增生,上肢功能恢复Fig. 1 The wound condition on admission; Fig. 2-4 The wound condition during the treatment; Fig. 5-6 During the follow-up 9 months after discharge, no obvious scar hyperplasia was observed on the healed skin, and both upper limbs can function normally
病例8:王某,男,48岁
患者以双下肢及臀部坏死性筋膜炎,臀部、髋部及骶尾部多处压疮,T12以下截瘫,创面脓毒症等为诊断于2016年6月26日收入院。专科检查:T12以下截瘫;双下肢、臀部、髋部及骶尾部可见多处溃疡创面,创面表层覆有大量恶臭味灰白色稀薄脓液;左侧膝关节以上及右侧大腿上2/3的皮肤与肌肉组织分离,且皮下与臀部及髋部创面贯通,探查可见大量脓液蓄积,波动感明显。患者入院后,在全身综合治疗的同时,创面全程采用烧伤创疡再生医疗技术联合分批次清创治疗。治疗246 d后,创面愈合,愈后皮肤留有轻度瘫痕增生,臀部外型丰满。出院后2年随访,骶尾部压疮复发,可见面积约4.0 cm×4.0 cm的溃疡创面,其余部位愈后皮肤弹性良好。(经治医院:石嘴山市第一人民医院;经治医师:李传吉,邓兴旺,齐旭辉)
图1 清创术后创面情况;图2-4 治疗过程中创面愈合情况;图5 治疗246 d后,创面愈合,愈后皮肤留有轻度瘫痕增生,臀部外型丰满;图6 出院后2年随访,骶尾部压疮复发,可见面积约4.0 cm×4.0 cm的溃疡创面,其余部位愈后皮肤恢复良好Fig. 1 The wound condition after debridement; Fig. 2-4 The wound condition during the treatment; Fig. 5 The wounds were healed after 246 days of treatment, there was mild scar hyperplasia on the healed skin, and the buttocks were plump; Fig. 6 During the follow-up two years after discharge, pressure ulcer at sacrococcygeal region relapsed, at the size of about 4.0 cm×4.0 cm, but skin at other healed sites had good elasticity
文章来源:《全国流通经济》 网址: http://www.qgltjj.cn/qikandaodu/2021/0627/893.html