重组牛碱性成纤维细胞生长因子联合藻酸盐敷料治疗老年人慢性溃疡创面

Effects of recombinant bovine basic fibroblast growth factor combined with alginate dressing on chronic ulcers of elderly patients

目的:观察外用重组牛碱性成纤维细胞生长因子(rb-bFGF)联合藻酸盐敷料治疗老年人慢性溃疡创面的临床效果。方法:将90例有慢性溃疡创面的老年患者按收治的先后顺序随机分为联合组(采用rb-bFGF联合藻酸盐敷料治疗)、bFGF组(采用rb-bFGF治疗)和常规组,每组30例。比较3组治疗第1、7、14、21天创面渗液量、色泽及愈合率,在第1、7天时行创面疼痛视觉模拟评分(VAPS),第1、14天时行生活质量(QOL)评分,第14天患者对疗效进行评价。结果:(1)3组间创面渗液量、色泽、愈合率比较差异有统计学意义(P<0.05),联合组改变最为显著,其后依次是bFGF组和常规组;(2)3组间创面疼痛VAPS评分比较差异有统计学意义(P<0.05),联合组疼痛减轻较bFGF组和常规组显著;(3)第14天,3组间患者QOL评分以及对治疗的自身效果评价比较差异有统计学意义(P<0.05),联合组优于bFGF组,而常规组则较差。结论:rb-bFGF联合藻酸盐敷料对减少创面渗液量、促进肉芽组织生长、加速再上皮化具有明显协同作用;同时可有效减轻创面疼痛,提高患者生活质量,两者联合可作为老年人慢性溃疡创面的治疗手段之一。

Objective： To explore clinical effect of recombinant bovine basic fibroblast growth factor （rb-bFGF） combined with alginate dressings in treatment of elderly patients with chronic ulcers. Methods： Ninety elderly patients with chronic ulcers were randomly divided into combined group （treated by rb-bFGF combined with alginate dressing ）, bFGF group （treated by rb-bFGF） and conventional group. Exudates amount, color and the healing rate of wound were compared at 1,7,14,21 d between the three groups. Visual analog pain score（VAPS） was carried out at 1,7 d. Quality of life （QOL） score was taken at 1,14 d and the self-evaluation of patients about the treatment was taken at 14 d. Results： （ 1 ） The wound exudates amount, color and healing rate of wound were significantly different among the three groups （ P 〈 0.05 ）, the combined group was best, followed by the bFGF groupand the conventional group. （2） VAPS score was significantly different among the three groups （ P 〈 0.05 ）, and compared with the bFGF group and the conventional group, there was significantly pain relief in the combined group. （3） There were significant differences in the QOL score and the effect of self-evaluation among the three groups at day 14 （P 〈 O. 05 ）, and the combined group was better than the bFGF group, while the conventional group was the worst. Conclusion：r b-bFGF combined with alginate dressing has coordination role in regulating wound exudates amount, promoting granulation tissue growth and accelerating re-epithelialization. It can reduce wound pain and improve quality of life of patients. As one of the means of treatment their combination can be used to repairing elderly patients with chronic ulcers.