削痂植皮联合外用重组人粒细胞-巨噬细胞刺激因子修复烧伤创面效果研究  

Effect of Escharectomy and Skin Grafting Combined with Recombinant Human Granulocyte/Macrophage Colony-stimulating Factor on Burn Wound

作　　者：吴晓伟[1] 李毅[1] 王洪瑾[1] 张科伟 WU Xiao-wei;LI Yi;WANG Hong-jin;ZHANG Ke-wei(Department of Burn Plastic Surgery,Affiliated Hospital of Qinghai University,Xining 810010,Qinghai,China)

机构地区：[1]青海大学附属医院烧伤整形科,青海西宁810010

出　　处：《中国美容医学》2020年第4期79-82,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究削痂植皮手术联合外用重组人粒细胞-巨噬细胞刺激因子(Recombinant human granulocyte/macrophage colony-stimulating factor,rhGM-CSF)对烧伤患者美容效果及满意率影响。方法:研究共计纳入125例烧伤患者,均为笔者医院2016年1月-2019年1月收治,采取随机数字表法将患者分为观察组和对照组,对照组患者(62例)采取削痂植皮手术治疗,观察组患者(63例)削痂植皮手术联合外用重组人粒细胞-巨噬细胞刺激因子治疗,比较两组患者美容效果、创面愈合时间及创面疼痛评分[视觉模拟疼痛法(Visual analogue scale,VAS)]、创面炎症评分及治疗前后创面边缘炎症因子白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平变化、患者治疗满意率。结果:观察组患者美容效果有效率(80.95%)高于对照组(64.52%),差异有统计学意义(P<0.05)。观察组患者创面炎症评分及VAS疼痛评分均优于对照组,创面愈合时间短于对照组,差异有统计学意义(P<0.01)。治疗前,两组患者创面边缘炎症因子(IL-1β、TNF-α)水平比较差异无统计学意义(P>0.05);治疗后各组患者IL-1β、TNF-α水平下降,观察组IL-1β、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗满意率(95.24%)显著高于对照组(83.87%),差异有统计学意义(P<0.05)。结论:削痂植皮手术联合外用重组人粒细胞-巨噬细胞刺激因子可提升烧伤患者临床疗效,美容效果佳,患者恢复好,疼痛轻,满意率高,值得推广以及应用。Objective To explore the effect of scab and skin grafting combined with recombinant human granulocyte/macrophage colony-stimulating factor(rhGM-CSF)on the cosmetic effect and satisfaction rate of burn patients.Methods A total of 125 burn patients were enrolled in the study,all of whom were admitted to our hospital from January 2016 to January 2019.The patients were divided into the observation group and the control group by random number table method.The patients in the control group(62 cases)were treated with escharectomy and skin grafting.The patients in the observation group(63 cases)were treated with escharectomy and skin grafting combined with rhGM-CSF.The results of beauty,wound healing time and wound pain score(VAS),the score of wound inflammation,the changes of IL-1βand TNF-αbefore and after treatment,and the satisfaction rate of patients of the two groups were compared.Results The effective rate of cosmetic effect in the observation group(80.95%)was higher than that in the control group(64.52%),the difference was statistically significant(P<0.05).The inflammatory score and VAS pain score in the observation group were better than those in the control group,and the wound healing time was shorter than that in the control group(P<0.01).Before treatment,there was no significant difference in the levels of inflammatory factors(IL-1β,TNF-α)between the two groups(P>0.05).After treatment,the levels of IL-1βand TNF-αdecreased in two groups,the levels of IL-1βand TNF-αin the observation group were lower than those in the control group(P<0.05).The treatment satisfaction rate in the observation group(95.24%)was significantly higher than that in the control group(83.87%,P<0.05).Conclusion Escharectomy and skin grafting combined with rhGM-CSF can improve the clinical effect of burn patients,with good cosmetic effect,good recovery of patients,light pain,high satisfaction rate,which is worthy of promotion and application.

关 键 词：烧伤 削痂植皮手术 外用重组人粒细胞-巨噬细胞刺激因子 美容效果 满意率 

分 类 号：R644[医药卫生—外科学]