创面床准备中使用重组人表皮生长因子后直接拉拢缝合修复骶尾部Ⅲ度褥疮  

Repairing sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after using rhEGF during wound bed preparation

作　　者：梁伟中[1] 赵作钧[1] 吴军玲[2] 钟伟[2] 周正[2] 

机构地区：[1]北京煤炭总医院整形外科,北京100028 [2]北京煤炭总医院普通外科

出　　处：《中华医学美学美容杂志》2010年第5期304-306,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的 探讨重组人表皮生长因子（recombinant human epidermal growth factor,rhEGF）加强创面准备后直接拉拢缝合修复骶尾部Ⅲ度褥疮的临床效果.方法 2007年1月至2009年10月,选择要求修复骶尾部Ⅲ度褥疮的就诊患者60例,褥疮面积3 cm×4 cm至10 cm×12 cm,病程15～70 d.随机均分为对照组和治疗组.治疗组创面除了常规换药外,还应用rhECF以强化创面准备;对照组创面仅常规换药,手术方式均为直接拉拢缝合.主要观察术后创面Ⅰ期愈合率及术后并发症发生率.结果 治疗组Ⅰ期愈合率达87%,术后并发症的发生率仅约13%;对照组术后Ⅰ期愈合率约70%,并发症的发生率达30%,两组间并发症与Ⅰ期愈合率分别比较,差异均具有统计学意义（P＜0.01）.结论 rhEGF强化创面准备后使后续手术治疗更加有效,不仅可以增加后续手术治愈率及减少术后并发症发生率,而且在筋膜层下便于剥离,血供充足.rhEGF联合直接拉拢缝合是一种简便、有效促进骶尾部Ⅲ度褥疮愈合的方法,尤其适合于高龄并且首次施行手术的患者.Objective To study the clinical efficacy of recombinant human epidermal growth factor （rhEGF） in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation （WBP）. Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant （P 〈 0.05）. Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.

关 键 词：创面床准备 重组人表皮生长因子 缝合 褥疮 

分 类 号：R6[医药卫生—外科学]