重组人表皮生长因子凝胶、负压封闭引流联合削痂植皮治疗深度烧伤患者的效果  

Effect of recombinant human epidermal growth factor gel, negative pressure drainage combined with escharectomy and skin grafting on patients with deep burn

作　　者：王君龙 韩自铭 WANG Junlong;HAN Ziming(Department of Burn and Plastic Surgery,Zhangjiagang Aoyang Hospital,Suzhou,Jiangsu 215600,China)

机构地区：[1]张家港澳洋医院烧伤整形科,江苏苏州215600

出　　处：《现代医学与健康研究电子杂志》2022年第24期20-23,共4页Modern Medicine and Health Research

摘　　要：目的 探究重组人表皮生长因子(rhEGF)凝胶、负压封闭引流联合削痂植皮治疗深度烧伤患者的效果及对炎症因子、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)水平的影响,为临床治疗该疾病提供依据。方法 选取2020年2月至2021年12月张家港澳洋医院收治的深度烧伤患者70例,按照随机数字表法分为两组,各35例。对照组患者采用创面削痂植皮手术进行治疗,在此基础上,观察组患者联合rhEGF凝胶、负压封闭引流治疗。均连续治疗7 d。对比两组患者临床指标,术前、术后7 d血清炎症因子、VEGF、MMP-9及TIMP-1水平,以及并发症发生情况。结果 观察组患者创面恢复时间显著短于对照组,植皮成活率显著高于对照组(P<0.05),两组患者手术时间比较,差异无统计学意义(P>0.05);与术前比,两组患者术后7 d白细胞计数(WBC)、血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)及MMP-9水平均显著降低,且观察组显著低于对照组;VEGF、TIMP-1水平均显著升高,且观察组显著高于对照组;观察组患者感染、积液、弹力性水疱、出血发生率均显著低于对照组(均P<0.05)。结论 采用rhEGF凝胶、负压封闭引流联合削痂植皮术治疗深度烧伤患者,可以提升治疗效果,减轻机体炎症反应,有利于新生血管生成,促进创面愈合,且安全性较高。Objective To explore the effect of recombinant human epidermal growth factor(rhEGF) gel, negative pressure sealing drainage combined with escharectomy and skin grafting on patients with deep burn and the influence on the levels of inflammatory factors, vascular endothelial growth factor(VEGF), matrix metalloproteinase-9(MMP-9) and tissue inhibitor of matrix metalloproteinase-1(TIMP-1), so as to provide basis for clinical treatment of the disease. Methods 70 cases of patients with deep burn admitted to Zhangjiagang Aoyang Hospital from February 2020 to December 2021 were selected and divided into two groups according to the random number table method, 35 cases in each group. The patients in the control group were treated with escharectomy and skin grafting, on this basis, patients in the observation group were treated with rhEGF gel and negative pressure sealing drainage. All patients were treated continuously for 7 days. The clinical indexes,serum levels of inflammatory factors, VEGF, MMP-9 and TIMP-1 before and 7 days after operation, and the incidence of complications were compared between the two groups. Results The wound recovery time of the observation group was significantly shorter than that of the control group, and the survival rate of skin graft was significantly higher than that of the control group;compared with before operation, the level of white blood cell count(WBC), and serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), C-reactive protein(CRP) and MMP-9 in the two groups all decreased significantly 7 days after, and the observation group was significantly lower than the control group;the levels of VEGF and TIMP-1 in the observation group were significantly higher than those in the control group;the incidence of infection, fluid accumulation,elastic blisters and bleeding in the observation group were significantly lower than those in the control group(all P<0.05). Conclusion rh EGF gel, negative pressure sealing drainage combined with escharectomy and skin grafting for patients with deep

关 键 词：深度烧伤 重组人表皮生长因子凝胶 负压封闭引流 削痂植皮 血管内皮生长因子 基质金属蛋白酶-9 基质金属蛋白酶组织抑制剂-1 

分 类 号：R622.1[医药卫生—整形外科]