面颈部瘢痕整形中应用皮肤软组织扩张器及rhEGF的效果

Application effect of skin soft tissue dilator and rhEGF in face and neck scar

目的探讨皮肤软组织扩张器治疗面颈部瘢痕中应用重组人表皮生长因子（rhEGF）的效果。方法选取2013年3月-2015年2月收治的烧伤致面颈部瘢痕患者50例,采用随机数字表法将患者分为观察组（n=24）和对照组（n=26）,对照组给予皮肤软组织扩张器治疗,观察组在对照组治疗的基础上加用rhEGF,观察两组扩张时间、皮肤扩张率、即时回缩率、羟脯氨酸（OHP）含量、Ⅰ/Ⅲ型胶原比值等指标。结果观察组扩张完成时间和即时回缩率分别为（32.97±5.11）d和（24.07±4.21）%,明显低于对照组（45.20±6.39）d和（37.40±6.10）%,差异比较有统计学意义（P〈0.05）;观察组皮肤扩张率为（140.11±10.47）%,明显高于对照组（85.20±13.21）%,差异比较有统计学意义（P〈0.05）;观察组OHP含量为（3.82±0.31）g/（mg·prot）,明显高于对照组（2.10±0.42）g/（mg·prot）,差异比较有统计学意义（P〈0.05）;观察组Ⅰ/Ⅲ型胶原比值为2.03±0.21,明显低于对照组2.82±0.41,差异比较有统计学意义（P〈0.05）。两组皮瓣均全部成活,效果较好。结论面颈部瘢痕整形中应用皮肤软组织扩张器和rhEGF治疗有较好的临床效果,可缩短扩张时间,减少软组织即时回缩率,值得临床推广使用。

Objective To investigate effect of skin soft tissue dilator and recombinant human epidermalgrowth factor（ rhEGF） in the treatment of face and neck scar. Methods From Mar. 2013 to Feb. 2015,50 patients with face and neck scar were selected and randomly divided into the observation group（ n = 24） and the control group（ n =26）. The control group was treated by skin and soft tissue dilator,and the observation group was treated by rhEGF and skin and soft tissue dilator. The indexes including dilation time,skin expansion rate,immediate retraction rate,hydroxyproline content and typeⅠ/Ⅲ collagen ratio were compared between the two groups. Results The expansion completion time and immediate retraction rates of the observation group were（ 32. 97 ± 5. 11） d and（ 24. 07 ±4. 21） %,respectively,which were significantly lower than those of the control group（ P〈0. 05）; the skin expansion rate in the observation group was（ 140. 11 ± 10. 47） %,significantly higher than that of the control group,with statistical difference（ P〈0. 05）; the hydroxyproline content of the observation group was（ 3. 82 ± 0. 31） g /（ mg·prot）,significantly higher than that of the control group,with statistical difference（ P〈0. 05）; the typeⅠ / Ⅲ collagen ratio in the observation group was（ 2. 03 ± 0. 21）,significantly lower than that of the control group,with significant difference（ P〈0. 05）. Skin flaps in the two groups were all survived with good effect. Conclusion Skin soft tissue dilator and rhEGF for treating face and neck scar can achieve good clinical results,can shorten the expansion time and reduce the immediate retraction rate of soft tissue. It is worthy of wide application in clinical practice.