重组人酸性成纤维细胞生长因子持续冲洗联合负压引流治疗难愈性皮肤溃疡的效果观察

Effect observation of recombinant human acidic fibroblast growth factor for continuous irrigation combined with negative pressure drainage in treatment of refractory skin ulcer

目的研究重组人酸性成纤维细胞生长因子（rh-a FGF）持续冲洗联合负压引流治疗难愈性皮肤溃疡的临床效果。方法收集2011年1月~2013年12月本院收治的皮肤溃疡难愈性创面患者55例,按照交替法分为观察组（29例）和对照组（26例）。观察组在冲洗液中加入5支rh-a FGF,即应用rh-a FGF持续冲洗联合负压引流进行治疗;对照组在冲洗液中加入等量生理盐水,联合负压引流进行治疗。记录治疗前后患者的皮肤深部组织外露面积及溃疡创面,由此计算皮肤溃疡伤腔容积减少值和创面愈合率。结果观察组皮肤溃疡创面在植皮或者短期换药后愈合,对照组皮肤溃疡创面要经过皮瓣移植或较长时间换药才有好转。两组创面愈合率、伤腔容积减少值比较,差异有统计学意义（P〈0.05）。结论 rh-a FGF持续冲洗联合负压引流治疗难愈性皮肤溃疡,可加速皮肤溃疡创面愈合,使达到替代治疗的目的,具有一定的临床意义,值得推广应用。

Objective To study the effect of recombinant human acidic fibroblast growth factor （rh-aFGF） for continu- ous irrigation combined with negative pressure drainage in the treatment of refractory skin ulcers. Methods 55 patients with refractory wound in skin ulcers treated in our hospital from January 2011 to December 2013 were selected,and were alternately divided into observation group （n=29） and control group （n=26）.rh-aFGF for continuous irrigation com- bined with negative pressure drainage was applied to observation group.The same volume of saline was added into the irrigation solution,and combined with negative pressure drainage was taken to control group.The exposed area and area of ulcerative wound in deep tissue of the skin before and after treatment in these participants was recorded in order to calculate the reduced value of wounded cavity in skin ulceration and rate of wound healing. Results In the observation group,skin ulcers healed after skin grafting or casual dressing;in the control group,skin ulcers was better go through the flap or longer dressing.The healing rate and wound cavity volume reduction value between the two groups had signifi- cant difference （P〈0.05）. Conclusion The study quickens the wound healing of skin ulcers and achieves the goals of al- ternative therapy with certain clinical significance,which is worthy of application and expansion.