上海交通大学学报(医学版) ›› 2022, Vol. 42 ›› Issue (5): 562-569.doi: 10.3969/j.issn.1674-8115.2022.05.002
收稿日期:
2022-01-24
接受日期:
2022-05-06
出版日期:
2022-05-28
发布日期:
2022-05-28
通讯作者:
刘琰,田鸣
E-mail:dongjiaoyun@hotmail.com;fayex3@126.com。;ly10515@rjh.com.cn;tianming198@163.com
作者简介:
董叫云(1976—),女,主管技师,学士;电子信箱:dongjiaoyun@hotmail.com基金资助:
DONG Jiaoyun(), SONG Fei(
), LU Shuliang, LIU Yan(
), TIAN Ming(
)
Received:
2022-01-24
Accepted:
2022-05-06
Online:
2022-05-28
Published:
2022-05-28
Contact:
LIU Yan,TIAN Ming
E-mail:dongjiaoyun@hotmail.com;fayex3@126.com。;ly10515@rjh.com.cn;tianming198@163.com
Supported by:
摘要:
目的·开发用于烧伤急救的、可快速降低皮肤温度并且对皮肤组织无刺激性的医疗用品——制冷喷雾剂和聚合物水凝胶。验证联合应用两者是否可快速阻断热源对皮肤组织的持续伤害,是否有利于创面的早期修复及降低烧伤创面的面积及深度。方法·将制冷液灌入高压罐中,评估制冷喷雾剂的制冷效果;制备水凝胶敷料,评估敷料的制冷时长;评估在大鼠背部皮肤连续使用制冷喷雾剂和水凝胶72 h后,对皮肤组织的刺激作用;建立大鼠烫伤模型,随机分为2组,每组6只,采用背部皮肤组织互相对比的方法,在烫伤区域使用制冷喷雾剂和水凝胶联合处理创面,分别与无处理组和自来水处理组做比较,24 h后评估烫伤部位的面积和创面炎症反应情况。结果·与普通自来水相比,15 %浓度的制冷喷雾剂的制冷效果最好,在3 min内,降温速度明显高于自来水对照组(P<0.05);水凝胶的冷却效果可维持8 h,可以在2 h内将70 ℃水的温度降至室温(22±2)℃,且水温全程低于对照组;2种材料对皮肤组织均无刺激性作用,未导致皮肤组织红斑、水肿等过敏反应。经制冷喷雾剂和水凝胶联合处理的烧伤创面,其焦痂面积显著减少,与无处理组及自来水处理组相比,均有统计学差异(P<0.05);H-E染色显示,与无处理组及自来水组相比较,联合应用制冷喷雾剂和水凝胶组的创面中,炎症细胞浸润的数量显著减少(P<0.05)。结论·制冷喷雾剂与聚合物水凝胶联合应用显示出良好的冷却效率,可减少焦痂面积、防止创面的不断加深及炎症细胞的聚集,有利于后期创面尽快愈合,且不会造成皮肤组织的过敏反应,可以作为烧伤患者急救管理的一种有效和方便的工具。
中图分类号:
董叫云, 宋菲, 陆树良, 刘琰, 田鸣. 制冷喷雾联合高分子水凝胶对急性烧伤创面的影响[J]. 上海交通大学学报(医学版), 2022, 42(5): 562-569.
DONG Jiaoyun, SONG Fei, LU Shuliang, LIU Yan, TIAN Ming. Effects of cryogen spray combined with polymeric hydrogel on acute burn wounds[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(5): 562-569.
Test | Skin response | Score |
---|---|---|
Erythema and eschar formation | No erythema | 0 |
Very slight erythema (barely perceptible) | 1 | |
Well-defined erythema | 2 | |
Moderate to severe erythema | 3 | |
Severe erythema (beet-redness) to slight eschar formation (injuries in depth) | 4 | |
Edema formation | No edema | 0 |
Very slight edema (barely perceptible) | 1 | |
Slight edema (edges of area well-defined by definite raising) | 2 | |
Moderate edema (raised approximately 1.0 mm) | 3 | |
Severe edema (raised more than 1.0 mm and extending beyond exposure area) | 4 | |
Total possible score for irritation | 8 |
表1 皮肤刺激试验的分级值
Tab 1 Grading values for the skin irritation test
Test | Skin response | Score |
---|---|---|
Erythema and eschar formation | No erythema | 0 |
Very slight erythema (barely perceptible) | 1 | |
Well-defined erythema | 2 | |
Moderate to severe erythema | 3 | |
Severe erythema (beet-redness) to slight eschar formation (injuries in depth) | 4 | |
Edema formation | No edema | 0 |
Very slight edema (barely perceptible) | 1 | |
Slight edema (edges of area well-defined by definite raising) | 2 | |
Moderate edema (raised approximately 1.0 mm) | 3 | |
Severe edema (raised more than 1.0 mm and extending beyond exposure area) | 4 | |
Total possible score for irritation | 8 |
Mean skin irritation intensity score | Intensity grading value |
---|---|
0‒<0.5 | No irritation |
0.5‒<2.0 | Sight irritation |
2.0‒<6.0 | Moderate irritation |
6.0‒<8.0 | Severe irritation |
表2 皮肤刺激强度分级值
Tab 2 Grading values for the skin irritation intensity
Mean skin irritation intensity score | Intensity grading value |
---|---|
0‒<0.5 | No irritation |
0.5‒<2.0 | Sight irritation |
2.0‒<6.0 | Moderate irritation |
6.0‒<8.0 | Severe irritation |
Formula | Cooling time/s | |||
---|---|---|---|---|
Repeat 1 | Repeat 2 | Repeat 3 | Average | |
Ordinary tap water | 49.57 | 43.83 | 45.65 | 46.35 |
10% cryogen spray | 35.68 | 40.87 | 40.00 | 38.85 |
15% cryogen spray | 31.72 | 34.60 | 33.50 | 33.27 |
20% cryogen spray | 34.50 | 31.15 | 34.80 | 33.48 |
表3 不同浓度制冷喷雾剂和普通自来水干预后的冷却速度
Tab 3 The cooling rate of cryogen spray with different concentrations and ordinary tap water
Formula | Cooling time/s | |||
---|---|---|---|---|
Repeat 1 | Repeat 2 | Repeat 3 | Average | |
Ordinary tap water | 49.57 | 43.83 | 45.65 | 46.35 |
10% cryogen spray | 35.68 | 40.87 | 40.00 | 38.85 |
15% cryogen spray | 31.72 | 34.60 | 33.50 | 33.27 |
20% cryogen spray | 34.50 | 31.15 | 34.80 | 33.48 |
图6 制冷喷雾剂与水凝胶联合干预对受伤皮肤伤口面积和焦痂区域(红色箭头所示)的影响Note:①P=0.028;②P=0.029.
Fig 6 Effects of cryogen spray combined with hydrogel on the wound and eschar areas in the wounded skin
图7 制冷喷雾剂与水凝胶联合使用后受伤皮肤组织学表现(H-E染色,×20)Note:①P=0.003;②P=0.036.
Fig 7 Histological observation of the wounded skin treated by cryogen spray combined with hydrogel (H-E staining, ×20)
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