高压氧联合人成纤维细胞生长因子治疗皮肤创伤效果  

Effect of hyperbaric oxygen combined with human fibroblast growth factor on treatment of skin trauma

作　　者：常和平[1] 王伟[2] 李旭[2] 叶凡[3] 

机构地区：[1]河北医科大学第三医院疼痛科,河北石家庄050051 [2]河北医科大学第三医院湘江院区骨二科,河北石家庄050035 [3]河北医科大学第三医院高压氧科,河北石家庄050035

出　　处：《中国临床研究》2018年第2期184-188,共5页Chinese Journal of Clinical Research

基　　金：河北省卫计委青年科技课题(20150300)

摘　　要：目的探讨高压氧联合人成纤维细胞生长因子治疗皮肤创伤的效果及对生长因子、炎性因子水平的影响。方法选取2010年3月至2016年6月80例皮肤创伤患者,根据治疗方法分为常规组(n=20)、生长因子组(n=20)、高压氧组(n=20)和联合组(n=20)。常规组采用常规治疗,生长因子组采用人成纤维细胞生长因子治疗,高压氧组采用高压氧治疗,联合组采用人成纤维细胞生长因子+高压氧治疗,四组均持续治疗至创面彻底愈合。统计四组创面愈合时间,治疗14 d后创面愈合效率,治疗前及治疗第2、7、14 d时转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)、结缔组织生长因子(CTGF)表达情况,肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平,不良反应发生率。结果四组创面愈合时间及创面愈合效率相比,差异有统计学意义(P均<0.01),且高压氧组及生长因子组创面愈合时间较常规组少,创面愈合效率较常规组高,联合组创面愈合时间较三组少,创面愈合效率较三组高,差异有统计学意义(P均<0.05);治疗前四组TGF-β1、VEGF、CTGF比较,差异无统计学意义(P均>0.05),治疗第2、7、14 d时四组TGF-β1、VEGF、CTGF较治疗前增高,且联合组各指标较其余三组高,差异有统计学意义(P均<0.01);治疗前四组CRP、TNF-α水平比较,差异无统计学意义(P均>0.05),治疗第2、7、14 d时四组CRP、TNF-α水平较治疗前降低,且联合组各指标较其余三组低,差异有统计学意义(P均<0.01);四组不良反应发生率相比,差异无统计学意义(P>0.05)。结论采用人成纤维细胞生长因子联合高压氧治疗皮肤创伤效果显著,可有效缩短创面愈合时间,改善创面愈合效果,减轻炎性反应程度,且不良反应发生率较低。Objective To investigate the effect of hyperbaric oxygen combined with human fibroblast growth factor（ FGF）in the treatment of skin wound and its influence on growth factors and inflammatory cytokines. Methods Eighty patients with skin trauma from March 2010 to June 2016 were selected and divided into routine group,FGF group,hyperbaric oxygen group and combined group（ FGF plus hyperbaric oxygen） according to different treatment methods（ n = 20,each）. The treatments on skin trauma were remained until wounds healed completely in all patients. The wound healing time and the rate of wound healing at 14 th day after treatment were recorded,the levels of transforming growth factor beta 1（ TGF-β1）,vascular endothelial growth factor（ VEGF）,connective tissue growth factor（ CTGF）,tumor necrosis factor alpha（ TNF-α）and C reactive protein（ CRP） were detected before treatment and at 2 nd-,7 th-,14 th-day after treatment,and the incidence of adverse reactions were observed in four groups. Results Compared with routine group,the wound healing time decreased,and the rate of wound healing increased in FGF group and hyperbaric oxygen group,while in combined group,the wound healing time decreased,and the rate of wound healing increased compared with the other three groups（ all P〈0. 05）. There were no significant differences in levels of TGF-β1,VEGF and CTGF before treatment among four groups（ all P〉0. 05）. At 2 nd-,7 th-,14 th-day after treatment,the levels of TGF-β1,VEGF and CTGF increased significantly compared with pre-treatment in four groups and were significantly higher in combined group than those in other three groups（ all P〈0. 01）. There were no significant differences in levels of CRP and TNF-α before treatment among four groups（ all P〉0. 01）. At 2 nd-,7 th-,14 th-day after treatment,levels of CRP and TNF-α decreased compared with pre-treatment among four groups and were statistically lower in combined group than those in other three groups（ all P〈0. 01）.

关 键 词：高压氧 人成纤维细胞生长因子 皮肤创伤 血管内皮生长因子 结缔组织生长因子 炎性因子 

分 类 号：R641[医药卫生—外科学]