负压引流联合重组人酸性成纤维细胞生长因子治疗难愈性创面的临床随机对照研究  

Randomized controlled clinical study of recombinant human acidic fibroblast growth factor and vacuum sealing drainage in the treatment of refractory wounds

作　　者：刘涛[1] 王鹏[2] 王勇岭 

机构地区：[1]河北省人民医院烧伤科,河北石家庄050051 [2]白求恩国际和平医院烧伤整形科,河北石家庄050082 [3]中国人民解放军第二五五医院烧伤科,河北唐山063000

出　　处：《海南医学》2015年第8期1141-1144,共4页Hainan Medical Journal

摘　　要：目的观察负压引流系统联合重组人酸性成纤维细胞生长因子(rh-a FGF,recombinant human acidic fibroblast growth factor)治疗难愈性创面的有效性及安全性。方法入选3个研究中心194例深Ⅱ度烧伤、Ⅲ度烧伤、糖尿病足溃疡、血管性慢性溃疡患者,根据随机数列表、多中心分层随机方法分为两组,治疗组98例,对照组96例。治疗组采用创面封闭式负压引流技术同时引流前,引流中给予rh-a FGF冲洗治疗。对照组采用VSD治疗,同时围引流期给予生理盐水水冲洗。连续治疗15 d,观察创面愈合情况。结果联合VSD治疗,rh-a FGF干预后肉芽组织生长评分显著高于对照组[(2.6±1.5)分vs(1.9±1.4)分,P=0.027],此外治疗组完全愈合时间[(14..6±5.2)d]比对照组[(19.5±7.9)d]短,治疗组住院时间[(13.4±4.7)d]明显短于对照组[(16.4±5.2)d],引流后残余创面面积明显[(15.4±1.9)cm2]明显小于对照组[(19.3±2.1)cm2],两组比较差异具有显著统计学意义。此外远期随访显示,rh-a FGF有利于降低愈合后创面感觉异常发生率,两组比较差异具有统计学意义(χ2=25.16,P=0.000)。结论负压引流与rh-a FGF联合治疗可显著促进肉芽组织生长,两者联合治疗可作为难愈性创面重要的治疗方案。Objective To study the effect of recombinant human acidic fibroblast growth factor （rh-aFGF） and vacuum sealing drainage （VSD） in the treatment of refractory wounds. Methods One hundred and ninety-four patients （Ⅱ, Ⅲ degree burning injury, diabetic foot ulcer, vascular chronic ulcer） with refractory wounds from 3 centers were randomly divided into two groups. The study group （n=98） were given rh-aFGF and VSD, and the control group （n=96） were only given VSD and normal saline. After 15 days of continuous treatment, the healing of wound was observed. Results Granulation score of the study group were significantly higher than the control group [（2.6±1.5） vs （1.9±1.4）, P=0.027]. And the healing time of the study group were significantly shorter than the control group [（14.6±5.2） d vs （19.5±7.9） d], as well as the length of hospital stay [（13.4±4.7） d vs （16.4±5.2） d]. The residual wound of the study group was significantly less than the control group [（15.4±1.9） cm^2 vs （19.3±2.1） cm^2]. There were statistically significant differences between the two groups. Long-time follow-up showed that the rh-aFGF can reduce paracenesthesia of wounds （Х^2=25.16, P=0.000）. Conclusion VSD combined with rh-aFGF can promote the growth of granulation tissue, which can be applied as a significant therapy for refractory wounds.

关 键 词：负压引流 重组人酸性成纤维细胞生长因子 难愈性创面 

分 类 号：R605[医药卫生—外科学]