纳米银敷料辅助治疗对深度大面积烧伤患者创面愈合及血清VEGF、EGF水平的影响  

The effect of nano silver dressing assisted therapy on wound healing,VEGF,and EGF levels in patients with deep and extensive burns

作　　者：高学坡 李茂清 贾鸿飞 Gao Xuepo;Li Maoqing;Jia Hongfei(Department of Burn,Zhangjiakou First Hospital,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院烧伤科,张家口075000

出　　处：《中国医师杂志》2024年第8期1211-1215,共5页Journal of Chinese Physician

基　　金：张家口市重点研发计划项目(2221098D)。

摘　　要：目的探究纳米银敷料辅助治疗对深度大面积烧伤患者创面愈合及血清血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)水平的影响。方法回顾性选择2022年5月至2023年5月张家口市第一医院收治的100例深度大面积烧伤患者,按不同治疗方法分为对照组、观察组,每组各50例。对照组选用重组人表皮生长因子进行治疗,观察组在对照组的基础上联合纳米银敷料治疗。对比分析两组的血清EGF、VEGF、肿瘤坏死因子α(TNF-α)、白细胞介素-10(IL-10)、细胞间黏附分子-1(ICAM-1)水平,恢复情况、疼痛数字评分量表(NRS)评分、创面愈合率,瘢痕颜色、厚度、血管分布及柔软度评分。结果治疗前,两组VEGF、EGF、TNF-α、IL-10、ICAM-1水平比较,差异无统计学意义(均P>0.05);治疗后,两组VEGF、EGF、IL-10、ICAM-1水平较治疗前升高,TNF-α水平较治疗前降低,且观察组VEGF、EGF、IL-10、ICAM-1水平高于对照组,TNF-α水平低于对照组,差异有统计学意义(均P<0.001)。与对照组比较,观察组烧伤分泌物消失时间、创面愈合时间、炎症症状消失时间均更短(均P<0.001)。换药后,观察组NRS评分低于对照组(P<0.001)。观察组第1、3、6个月创面愈合率高于对照组(均P<0.001)。治疗后6个月,两组颜色、厚度、血管分布、柔软度评分低于治疗前,且观察组低于对照组(均P<0.001)。结论对深度大面积烧伤患者使用纳米银敷料辅助治疗,可缩短创面愈合时间,改善EGF、VEGF、ICAM-1水平,减轻炎症反应,改善病情。ObjectiveTo investigate the effect of nano silver dressing as adjuvant therapy on wound healing,vascular endothelial growth factor(VEGF),and epidermal growth factor(EGF)levels in patients with deep and extensive burns.MethodsA total of 100 patients with deep and extensive burns admitted to the Zhangjiakou First Hospital from May 2022 to May 2023 were retrospectively selected and divided into a control group and an observation group according to different treatment methods,with 50 patients in each group.The control group was treated with recombinant human epidermal growth factor,while the observation group was treated with nano silver dressing in addition to the control group.A comparative analysis was conducted on the levels of serum EGF,VEGF,tumor necrosis factor alpha(TNF-α),interleukin-10(IL-10),and intercellular adhesion molecule-1(ICAM-1)between two groups,as well as their recovery status,pain rating scale(NRS)score,wound healing rate,scar color,thickness,vascular distribution,and softness score.ResultsBefore treatment,there was no statistically significant difference in the levels of VEGF,EGF,TNF-α,IL-10,and ICAM-1 between the two groups(all P>0.05);After treatment,the levels of VEGF,EGF,IL-10,and ICAM-1 increased in both groups,while the level of TNF-αdecreased.The observation group had higher levels of VEGF,EGF,IL-10,and ICAM-1 than the control group,and lower levels of TNF-αthan the control group,with statistically significant differences(all P<0.001).Compared with the control group,the observation group had a shorter disappearance time of burn secretions,wound healing time,and inflammation symptoms(all P<0.001).After dressing change,the NRS score level of the observation group was lower than that of the control group(P<0.001).The wound healing rate in the observation group was higher than that in the control group at 1,3,and 6 months(all P<0.001).After 6 months of treatment,the color,thickness,vascular distribution,and softness scores of both groups were lower than before treatment,and the observati

关 键 词：烧伤 纳米银敷料 创面愈合 血管内皮生长因子 表皮生长因子 

分 类 号：R644[医药卫生—外科学]