联合bFGF的负压创面治疗技术在难治性压力性溃疡治疗中的应用

Clinical observations of negative pressure wound therapy and basic fibroblast growth factor in thetreatment of intractable pressure ulcer

目的观察联合碱性成纤维细胞生长因子（bFGF）的负压仓0面治疗（NPWT）技术在难治性压力性溃疡创面治疗中的应用。方法将2008年7月至2011年12月大连医科大学附属威海市立医院收治的48例符合入选标准的难治性压力性溃疡患者随机分成试验组和对照组，每组24例。除常规治疗外，试验组应用NPWT联合bFGF进行治疗，对照组应用NPWT进行治疗。治疗期间定期测量溃疡大小，比较两组创面肉芽形成时间及治疗后第7、14天的创面缩小率、术前创面处理时间、术前治疗费用。结果试验组的肉芽形成时间、治疗后第7、14天的创面缩小率、术前创面处理时间、术前总治疗费用分别为（10．84-2．7）d、10．1％4±2．9％、22．3％±3．1％、（18．2±2．6）d、（7946±245）元（人民币，下同），对照组上述指标分别为（16．34±3．9）d、6．9％±1．9％、13．4％4±2．8％、（27．14±3．3）d、（10.951±285）元，两组差异均有统计学意义（均P〈0．01）。结论NPWT联合bFGF治疗难治性压力性溃疡创面的效果较好，且费用较低。

Objective To observe the clinical efficacies and costs of negative pressure wound therapy （NPWT） and basic fibroblast growth factor （bFGF） in the treatment of stage Ⅲ or Ⅳ pressure ulcer （PU）. Methods From July 2008 to December 2011,48 patients fulfilling the study inclusion or exclusion criteria at Weihai Municipal Hospital were divided randomly into experiment and control groups （ n = 24 each）. On the basis of routine treatment and NPWT of each inpatient, the patients in the experiment group were treated with bFGF. The changes of healing rate of PU were measured at Days 7 and 14 post-treatment in each group. Meanwhile, the granulation duration, preoperative time and total preoperative cost were compared. Results The granulation duration, healing rate of Days 7 and 14, preoperative time and total preoperative cost in the experiment group was （ 10. 8±2. 7 ） days, 10. 1%±2. 9% , 22. 3% ± 3.1%, （18.2±2.6） days and （7946±245） yuan RMB versus （16.3±3.9） days, 6.9% ±1.9%, 13.4% ±2. 8%, （27. 1 ± 3.3） days and （10 951 ± 285） yuan RMB in the control group respectively. The differences between two groups were statistically significant （ all P 〈 0. 01 ）. Conclusion As a preoperative therapeutic modality of intractable PU, NPWT and bFGF offer better therapeutic efficacies and lower therapeutic costs as compared with NPWT alone.