生长激素在严重烧伤中的应用

The Use of Growth Hormone in the Treatment of Patients with Severe Burns

目的 :观察生长激素对严重烧伤患者蛋白质代谢、创面愈合、抗感染及愈后的作用。方法 :3 6例大面积烧伤患者随机分为治疗组和对照组各 18例 ,两组均给予营养支持、外科手术及抗感染治疗 ,治疗组加用重组人生长激素(rhGH) ,自手术后第 1天开始给予rhGH 0 .2U·kg 1,sc ,疗程 10～ 2 0d ,平均 15d。比较两组一般情况、蛋白质代谢、植皮区和供皮区创面愈合时间、伤后第 3 0天全身创面愈合率及住院时间。结果 :治疗组一般情况良好 ,体重下降减小 ,血浆蛋白升高、术后抗生素应用剂量减小 ,抗生素应用时间、植皮区和供皮区愈合时间、住院时间均缩短 (P <0 .0 5或P <0 .0 1)。结论 :rhGH能促进蛋白质合成 ,缩短创面愈合时间 。

Objective:To survey the effects of recombinant human growth hormone (rhGH) on the protein metabolism, healing of wound surface, anti infective capability and prognosis in adult patients with severe burns. Methods:36 patients with severe burns with wound surfaces covering more than 60% of total body surface area (TBSA) were enrolled in this placebo controlled prospective study. They were comparable in nutrient intake, TBSA, and full thickness burn areas. Patients of both the treatment group and control group were subjected to supportive therapy with nutrients, surgical operation and anti infective management. 18 patients of the treatment group were given each rhGH subcutaneously in a dose of 0.2 U·kg 1 at 8 am each morning for 10～20 consecutive days beginning from postoperation day 1. Patients of the control group were given normal saline as placebo. The general condition, protein catabilisn, healing time of wound area and autologous skin donor site healing rate of the total wound surface on the 30th day after burn and duration of hospitalization of patients of the two groups were compared. Results:In patients of the treatment group, there was a better general condition, smaller decrease in body weight and smaller amount of antibiotics needed postoperatively. The duration of the use of the healing time of autologous skin pulp grafting and donor sites, and the period of hospitalization in patients of the treatment group were significantly shorter than those in patients of the control group. Conclusion:rhGH was found to promote protein anabolism, shorten the time of wound surface healing, enhance immunity and shorten the period of hospitalization in patients with severe burns.