【作者】 姜辉；

【导师】 王明喜；

【作者基本信息】 山东中医药大学 ， 中医骨伤科学， 2007， 硕士

【摘要】 目的：探讨毁损性手外伤的早期临床治疗方法。方法：通过对45只SD大白鼠组织缺损感染创面造模，后随机分为中药组、洗必泰组、空白对照3组，每组15只，后于不同时间段观察创面大小、并取创面组织做细菌含量测定及病理切片。将100例手部一元或多元组织毁损缺失患者，随机分成中药湿敷组及洗必泰湿敷组，观察湿敷后的疼痛指数、肿胀指数、组织坏死和渗出指标。结果：动物实验显示中药组、对照组的细菌含量少于空白对照组，有统计学差异(P＜0.01)。创面大小上，中药组随着时间推移明显缩小，与对照组、空白对照组均有显著差异(P＜0.01)。肉眼观察创面情况，中药组肉芽组织生长良好，创面很快变浅，病理结果显示中药组有大量巨噬细胞，对照组与空白对照组仅以明显组织坏死和炎性细胞浸润。通过对早期湿敷毁损性手外伤创面的临床对比研究，对照组(洗必泰)，显示中药三黄愈疡汤可起到消肿止痛，减少渗出，抑制细菌繁殖，延缓继发组织坏死作用。亚急症组合组织移植40例顺利成活。结论：采用中药三黄愈疡液早期湿敷开放污染创面，亚急症组合组织移植为毁损性手外伤早期的理想治疗方法。更多还原

【Abstract】 Objective: To discuss the early clinical treatment of destroyed hand injuriesMethods: Destroyed infected wound surface with tissue defect model was established in 45 SD rats, and divided into 3 groups Chinese herb group Xi Bi Tai (XBT) group and control group randomly, 15 in each group. In different times, the size of wound bacterial content in wound surface and pathological section were observed. 100 patients of hand tissue injuries were divided into Chinese herb wet spread and XBT wet spread group, tissue necrosis and pain swelling and exudation indexes were studied in each group.Results: The results of experimental study showed bacterial content in Chinese herb group and XBT group was less than control group significantly (P<0.01) , the size of wound was greatly smaller than the other groups (P<0.01) . By observing the wound surface, we found granulation tissue in Chinese herb group grew better, the wound shallowing faster and pathological results showed lots of macrophages in wound in Chinese herb group. In XBT and control group, the results represented as tissue necrosis and inflammatory cytokines infiltration. Results of clinical contrast study of wet spread in early destroyed hand injuries showed Sanhuang curing decoction can reduce swelling ease pain decrease exudation and inhibit exudation, while alleviating secondary tissue necrosis. The application of combined tissue transplantation in 40 cases subacute patients was all successfulConclusion: The using of Chinese herb Sanhuang curing decoction wet spread in early patency contaminated wound together with combined tissue transplantation in subacute phase was the ideal therapy in early destroyed hand injuries.更多还原