磺胺嘧啶银霜联合rhGM-CSF凝胶制剂治疗对深Ⅱ度烧伤创面溶痂的影响  

Effects of sulfadiazine silver emulsion combined with rhGM-CSF gel preparation on wound dissolution of deep second degree burns

作　　者：张宏峰[1] 高栋梁[1] 赵朋来 ZHANG Hong-feng;GAO Dong-liang;ZHAO Peng-lai(Department of Burns and Plastic Surgery,Yan'an University Affiliated Hospital,Yan'an 716000,Shaanxi,CHINA;Department of Burns and Plastic Surgery,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]延安大学附属医院烧伤整形科,陕西延安716000 [2]榆林市中医医院烧伤整形科,陕西榆林719000

出　　处：《海南医学》2022年第7期887-890,共4页Hainan Medical Journal

基　　金：陕西省延安大学附属医院科学技术研究发展计划项目(编号:2021PT-09)。

摘　　要：目的观察磺胺嘧啶银(SD-Ag)霜联合重组人粒细胞巨噬细胞刺激因子(rhGM-CSF)凝胶制剂治疗对深Ⅱ度烧伤创面溶痂的影响。方法回顾性分析2017年5月至2019年5月延安大学附属医院烧伤整形科及榆林市中医医院烧伤整形科收治的78例深Ⅱ度烧伤患者的临床资料,根据治疗方式分为SD-Ag霜+rhGM-CSF凝胶制剂组(联合组,n=32)和SD-Ag组(n=46)。于治疗前(T0)及治疗后第14天(T3)时评估两组患者的创面渗出量、创缘反应情况,比较两组患者的完全溶痂时间、完全愈合时间以及治疗后第6天(T1)、第10天(T2)、T3时的溶痂率和愈合率。结果两组患者T3时的创面渗出量评分均较T0时降低,且联合组患者的创面渗出量评分明显低于SD-Ag组,差异均有统计学意义(P<0.05);两组患者T3时创面创缘反应评分均较T0时降低,且联合组患者的创面创缘反应评分明显低于SD-Ag组,差异均有统计学意义(P<0.05);联合组患者的完全溶痂时间为(8.23±2.53)d,明显短于SD-Ag组的(13.17±3.14)d,T1~T3时溶痂率分别为(71.23±7.84)%、(90.32±8.72)%、(98.61±4.26)%,明显高于SD-Ag组的(58.48±5.81)%、(84.51±6.54)%、(92.14±7.93)%,差异均有统计学意义(P<0.05);联合组患者的完全愈合时间为(15.81±1.64)d,明显短于SD-Ag组的(19.83±1.77)d,T1~T3时愈合率分别为(59.22±7.16)%、(78.28±8.47)%、(95.64±11.13)%,高于SD-Ag组的(47.35±6.23)%、(67.21±7.94)%、(80.16±9.26)%,差异均有统计学意义(P<0.05)。结论SD-Ag霜联合rhGM-CSF凝胶制剂治疗深Ⅱ度烧伤创面有助于改善创面渗出量及创缘反应,加速创面溶痂,促进创面愈合,于患者病情改善有利。Objective To observe the effects of sulfadiazine silver(SD-Ag)emulsion combined with recombinant human granulocyte macrophage colony stimulating factor(rhGM-CSF)gel preparation on wound dissolution of deep second degree burns.Methods The clinical data of 78 patients with deep second degree burns in Department of Burns and Plastic Surgery,Yan’an University Affiliated Hospital and Yulin Hospital of Traditional Chinese Medicine between May 2017 and May 2019 was retrospective analyzed.According to the treatment methods,the patients were divided into SD-Ag emulsion+rhGM-CSF gel preparation group(combined group,n=32)and SD-Ag group(n=46).The wound exudation volume and wound edge response were evaluated in the two groups before treatment(T0)and at 14 d after treatment(T3).The complete dissolution time,complete healing time,dissolution rate,and healing rate at 6 d(T1)and 10 d(T2)after treatment and at T3 were compared between the two groups.Results At T3,the wound exudation score in both groups was significantly reduced compared with that at T0,and the wound exudation score in combined group was significantly lower than that in SD-Ag group,with statistically significant difference(P<0.05).The wound edge response score at T3 in the two groups was significantly lower than that at T0,and the wound edge response score was significantly lower in combined group than that in SD-Ag group,with statistically significant differences(P<0.05).The complete dissolution time was(8.23±2.53)d in combined group,significantly shorter than(13.17±3.14)d in SD-Ag group,and the dissolution rates at T1,T2,T3 were(71.23±7.84)%,(90.32±8.72)%,and(98.61±4.26)%,significantly higher than(58.48±5.81)%,(84.51±6.54)%,and(92.14±7.93)%in SD-Ag group(P<0.05).The complete healing time in combined group was(15.81±1.64)d,significantly shorter than(19.83±1.77)d in SD-Ag group,and at T1,T2,T3,the healing rates were(59.22±7.16)%,(78.28±8.47)%,and(95.64±11.13)%,significantly higher than(47.35±6.23)%,(67.21±7.94)%,and(80.16±9.26)%in SD-Ag group(P<

关 键 词：深Ⅱ度烧伤 磺胺嘧啶银 重组人粒细胞巨噬细胞刺激因子 创面溶痂 创面愈合 

分 类 号：R644[医药卫生—外科学]