重组人表皮生长因子联合纳米银敷料治疗烧伤的效果及对血清炎性因子的影响  

Effect of Recombinant Human Epidermal Growth Factor Combined with Nano-silver Dressing on Burn and ItsImpact on Serum Inflammatory Factor Level

作　　者：李茂清 贾鸿飞 高学坡 LI Maoqing;JIA Hongfei;GAO Xuepo(Department of Burn,the First Hospital of Zhangjiakou City,Zhangjiakou,Hebei 075000,China)

机构地区：[1]张家口市第一医院烧伤科,河北张家口075000

出　　处：《临床误诊误治》2024年第4期75-79,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省2022年度医学科学研究项目(20221883);张家口市科技局2022重点研发计划项目(2221098D)。

摘　　要：目的探讨重组人表皮生长因子联合纳米银敷料治疗烧伤的效果及对血清炎性因子等的影响。方法选取2020年1月—2022年1月收治的烧伤100例为研究对象,按照不同的治疗方式将其分成2组,每组50例。对照组采用重组人表皮生长因子治疗,观察组在对照组治疗基础上增加纳米银辅料治疗。比较2组治疗前后血清细胞间黏附因子-1(ICAM-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平,统计2组烧伤分泌物细菌培养阳性率、炎性症状消失时间及创面愈合时间,使用疼痛数字评分法(NRS)对患者治疗前后创面疼痛情况进行评估,统计2组创面愈合率并使用温哥华瘢痕量表(VSS)对2组瘢痕情况予以评估,比较2组治疗期间不良反应发生情况。结果与治疗前相比,治疗7 d后2组血清ICAM-1、TNF-α均降低,血清IL-10均升高,且观察组变化更显著(P<0.01)。观察组治疗7和14 d后烧伤分泌物细菌培养阳性率均低于对照组(P<0.05)。观察组炎性症状消失时间、创面愈合50%所需时间、创面愈合80%所需时间、创面愈合100%所需时间均短于对照组,创面愈合率高于对照组(P<0.01,P<0.05)。与治疗前相比,2组治疗14 d后NRS评分和治疗6个月后VSS评分均降低,且观察组低于对照组(P<0.01)。结论重组人表皮生长因子联合纳米银敷料治疗烧伤可促进创面愈合,改善创面疼痛程度,降低血清炎性因子水平。Objective To investigate the effect of recombinant human epidermal growth factor(rh-EGF)combined with nano-silver dressing in the treatment of burn patients and its impact on wound healing,pain,and serum inflammatory factor levels.Methods A total of 100 patients with burn treated from January 2020 to January 2022 were selected as the research subjects and divided into two groups according to different treatment methods,with 50 patients in each group.The control group was treated with rh-EGF,and the observation group was supplemented with nano-silver dressing on the basis of the control group.The levels of intercellular adhesion factor-1(ICAM-1),interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)were compared between the two groups before and after treatment,and the time of burn secretions,the disappearance of inflammatory symptoms and the time of wound healing in the two groups were recorded.The wound pain during dressing change before and after treatment was evaluated by numerical pain score(NRS).The wound healing rate of the two groups was calculated,the scar condition of the two groups was evaluated by Vancouver Scar Scale(VSS),and the incidence of adverse reactions in the two groups was analyzed.Results Compared with those before treatment,the levels of serum ICAM-1 and TNF-αwere decreased and IL-10 was increased in the two groups at 7 d after treatment,and the changes were more significant in observation group(P<0.01).At 7 and 14 d after treatment,the positive rate of burn secretion culture in the observation group was lower than that in the control group(P<0.05).The disappearance time of inflammatory symptoms,the time of 50%wound healing,the time of 80%wound healing and the time of 100%wound healing in the observation group were shorter than those in the control group,and the wound healing rate was higher than that in the control group(P<0.01,P<0.05).NRS scores at 14 d after treatment and VSS score at 6 months after treatment in both groups were lower than those before treatment,which were lower in t

关 键 词：烧伤 表皮生长因子-1 纳米银敷料 细胞间黏附因子-1 白细胞介素-10 肿瘤坏死因子-α 瘢痕 疼痛 

分 类 号：R644[医药卫生—外科学]