重组人粒细胞巨噬细胞集落刺激因子凝胶治疗老年患者腹泻致肛周皮肤糜烂的效果

Effect of Recombinant Human Granulocyte Macrophage Colony-Stimulating Factor Gel on the Treatment of Perianal Skin Erosion Caused by Diarrhea in Elderly Patients

目的评价重组人粒细胞巨噬细胞集落刺激因子(recombinant human granulocyte-macrophage colony stimulating factor,rhGM-CSF)凝胶治疗老年患者腹泻致肛周皮肤糜烂的疗效。方法便利抽样法选取2010年7月至2012年7月,解放军第98医院消化内科收治的老年患者腹泻致肛周皮肤糜烂67例为研究对象。按照入院单双号分为对照组(n=32)和观察组(n=35)。观察组患者采用rhGM-CSF凝胶外敷,而对照组患者采用凡士林油膏外敷,比较两组患者创面愈合时间、不同时间点创面愈合率及用药后不良反应。结果观察组患者完全愈合时间为(5.5±2.3)d,对照组为(8.9±3.2)d,差异有统计学意义(t=5.824,P=0.043)。重复测量的方差分析显示:治疗期间,两组患者愈合率随时间的延长均呈上升趋势。两组处理因素的差异有统计学意义(P<0.05),认为rhGM-CSF凝胶剂与凡士林油膏对患者创面的疗效不同。治疗期间两组均未见明显不良反应。结论 rhGM-CSF凝胶剂能显著促进老年腹泻致肛周皮肤糜烂创面的愈合,安全有效,方便护理。

Objective To evaluate the effect of recombinant human granulocyte macrophage colony-stimulating fac- tor gel on the treatment of perianal skin erosion caused by diarrhea in elderly patients.Methods By convenience sam- pling,67 patients with perianal skin erosion caused by diarrhea were selected and divided into control group （n=32） and observation group （n = 35）.The observation group was treated with rhGM-CSF gel, while the control group was treated with petrolatum ointment.Wound healing time,healing rate at different time points and adverse reactions after treatment were compared between two groups. Results The completed healing time of rhGM-CSF gel group was （5.5 ±2.3）d,while vaseline ointment group was （8.9± 3.2）d（t =5.824,P=0.043）.The repeated measures analysis of variance showed that the wound healing rates in both groups were increased with time extended.There was statistical significance of the differences of treatment factor between two groups（P〈0.05）.Wound healing effects of rhGM-CSF gel and vaseline ointment were different. No adverse reaction showed in the treatment period with the two methods. Conclusion rhGM-CSF gels can significantly promote the healing of perianal skin erosion caused by diarrhea in elderly patients.Nursing with rhGM-CSF gels is a safe,effective and convenient method.