重组酸性成纤维细胞生长因子持续冲洗合并负压引流治疗难愈性皮肤溃疡的临床观察

Continuous irrigation with recombinant human acid fibroblast growth factor combined with negative-pressure drainage for the treatment of refractory skin ulcer

目的 探讨重组酸性成纤维细胞生长因子（rh-aFGF）持续冲洗合并负压引流治疗难愈性皮肤溃疡的临床疗效.方法 选择2010年1月至2012年12月救治的难愈性皮肤溃疡患者60例,分为3组.A组20例,皮肤溃疡使用rh-aFGF持续冲洗合并负压引流治疗;B组20例,于清创术后,使用rh-aFGF喷涂创面后包扎,每日换药1次;C组20例,于清创后给予常规换药油纱贴覆,外层以纱布包扎.3组均常规每日换药,总疗程21d.结果 观察7、14、21d,A组皮肤溃疡上皮或肉芽生长良好,深部组织外露面积和伤腔容积缩小,愈合率和伤腔容积好转率均显著高于其他两组（P＜0.01）.结论 使用rh-aFGF持续冲洗合并负压引流可用于治疗难愈性皮肤溃疡.

Objective To evaluate the clinical efficacy of continuous irrigation with recombinant human acid fibroblast growth factor （rh-aFGF） combined with negative-pressure drainage in the treatment of refractory skin ulcer.Methods A clinical trial was performed from January 2010 to December 2012.Sixty patients with refractory skin ulcer were randomly and equally classified into three groups：group A receiving continuous irrigation with rhaFGF combined with negative-pressure drainage,group B receiving irrigation of raw surfaces with rh-aFGF followed by bandaging after debridement,group C receiving covering of raw surfaces with Vaseline gauze and absorbent gauze followed by bandaging after debridement.Dressings were changed once daily in every group.The treatment lasted 21 days.The efficacy of these regimens was evaluated on day 7,14 and 21.Results At the above time points for observation,both the granulation and epithelium tissues of ulcers grew well in group A,with a decrease in the volume of wounds and area of exposed deep tissues.There was a significant increase in the cure rate and reduction rate of wound volume in group A compared with the other two groups （all P ＜ 0.01）.Conclusion Refractory dermal ulcer can be treated with continuous irrigation with rh-aFGF combined with negative-pressure drainage.