自体富血小板凝胶联合外用重组人碱性成纤维细胞生长因子对烧伤难愈合创面的治疗效果观察  

Therapeutic effect of autologous platelet-rich gel combined with external recombinant human basic fibroblast growth factor on refractory burn wounds

作　　者：白冰[1] 王静[1] 刘应平 郭忠梁 Bai Bing;Wang Jing;Liu Yingping;Guo Zhongliang(Department of Burn Plastic Wound Surgery,Suining Central Hospital,Suining Sichuan 629000,China)

机构地区：[1]四川省遂宁市中心医院烧伤整形创面外科,四川遂宁629000

出　　处：《中国医刊》2025年第4期410-414,共5页Chinese Journal of Medicine

摘　　要：目的探讨自体富血小板凝胶(APG)联合外用重组人碱性成纤维细胞生长因子(rh-bFGF)治疗烧伤难愈合创面的临床效果。方法选取2020年6月至2023年6月四川省遂宁市中心医院收治的烧伤难愈合创面患者123例,采用随机数字表法分为APG组、rh-bFGF组及联合组,每组41例。三组均给予常规治疗,在此基础上,APG组给予APG治疗,rh-bFGF组给予外用rh-bFGF治疗,联合组给予APG联合外用rh-bFGF治疗。比较三组的治疗有效率、创面愈合时间、住院时间,采用Bates-Jensen伤口评估工具(BWAT)评估创面愈合情况,视觉模拟量表(VAS)评分评估创面疼痛情况,并比较三组肉芽组织中碱性成纤维细胞生长因子(bFGF)和表皮生长因子(EGF)mRNA的表达水平。术后1个月、6个月随访时采用温哥华瘢痕评定量表(VSS)评估创面瘢痕情况,并比较三组的并发症发生率。结果联合组治疗总有效率高于APG组和rh-bFGF组,创面愈合时间、住院时间短于APG组和rh-bFGF组,且APG组短于rh-bFGF组,差异有统计学意义(P<0.05)。治疗前三组BWAT评分、VAS评分及肉芽组织中bFGF、EGF mRNA表达水平比较差异无统计学意义(P>0.05);治疗14 d后,三组BWAT评分、VAS评分均低于治疗前,且联合组低于APG组、rh-bFGF组,APG组低于rh-bFGF组,而肉芽组织中bFGF、EGF mRNA表达水平均高于治疗前,且联合组高于APG组、rh-bFGF组,APG组高于rh-bFGF组,差异有统计学意义(P<0.05)。术后1个月、6个月随访时,联合组创面VSS评分低于APG组和rh-bFGF组,且APG组低于rh-bFGF组,差异有统计学意义(P<0.05)。三组术后并发症发生率比较差异无统计学意义(P>0.05)。结论APG联合rh-bFGF治疗烧伤难愈合创面的疗效显著,可明显促进创面愈合,缓解疼痛,上调肉芽组织中生长因子的表达水平,减轻创面瘢痕。Objective To investigate the clinical effect of autologous platelet-rich gel(APG)combined with topical recombinant human basicfibroblast growth factor(rh-bFGF)in the treatment of refractory burn wounds.Method A total of 123 patients with refractory burn wounds admitted to Suining Central Hospital in Sichuan Province from June 2020 to June 2023 were selected and randomly divided into three groups using a random number table method:APG group,rh-bFGF group,and combined group,with 41 patients in each.All three groups received conventional treatment.On this basis,the APG group was treated with APG,the rh-bFGF group was treated with topical rh-bFGF,and the combined group was treated with a combination of APG and topical rh-bFGF.The treatment efficacy,wound healing time,and hospitalization duration were compared among the three groups.The Bates-Jensen Wound Assessment Tool(BWAT)was used to assess wound healing,and the Visual Analogue Scale(VAS)score was used to evaluate wound pain.The expression levels of basic fibroblast growth factor(bFGF)and epidermal growth factor(EGF)mRNA in granulation tissue were compared among the three groups.At 1-month and 6-month follow-ups after surgery,the Vancouver Scar Scale(VSS)was used to assess scar formation in the wounds,and the incidence of complications was compared among the three groups.Result The combined treatment group exhibited a higher overall efficacy compared to both the APG group and the rh-bFGF group.The wound healing time and hospitalization duration were shorter in the combined group than in the APG and rh-bFGF groups,with the APG group being shorter than the rh-bFGF group.The differences were statistically significant(P<0.05).Prior to treatment,there were no significant differences in BWAT scores,VAS scores,and levels of bFGF and EGF in granulation tissue among the three groups(P>0.05).After 14 days of treatment,the BWAT and VAS scores in all three groups were lower than those before treatment,with the combined group scoring lower than the APG and rh-bFGF groups,and t

关 键 词：烧伤难愈合创面 自体富血小板凝胶 碱性成纤维细胞生长因子 表皮生长因子 

分 类 号：R644[医药卫生—外科学]