后躯干瘢痕皮修复联合血浆外敷对烧伤创面中细胞因子的影响

Effects of post-trunk scar skin repair combined with plasma application on cytokines in burn wounds

目的 探讨大面积深度烧伤患者使用后躯干瘢痕皮修复联合血浆外敷对创面中细胞因子的影响。方法选取2013年1月-2016年1月我院烧伤整形科接受治疗的40例Ⅲ度烧伤患者,按随机数字表法分为观察组和对照组,每组20例,均选取后躯干瘢痕皮对瘢痕创面进行修复;观察组在此基础上联合血浆外敷。观察两组患者平均愈合率及愈合时间、创面处表皮细胞生长因子（EGF）、肿瘤细胞坏死因子（TNF-α）的表达。结果 治疗7 d、14 d、21 d后,观察组的愈合率均高于对照组（P〈0.05）,观察组平均愈合时间短于对照组（P〈0.05）。40例接受瘢痕修复的患者其瘢痕皮存活率为100%,对照组患者中后躯干同一部位接受2次供皮患者3例,3次供皮患者2例,观察组未出现2次及以上次数供皮患者。治疗7 d、14 d、21 d后,观察组TNF-α的表达均低于对照组（P〈0.05）,观察组EGF的表达均高于对照组（P〈0.05）。在治疗过程中,两组患者均未出现不良反应。结论 对患者使用后躯干瘢痕皮修复联合血浆外敷进行后期修复效果较好,可显著缩短愈合期,并有可能是通过调节创面EGF、TNF-α的表达发挥作用,值得在临床中进行推广。

Objective To study the effects of post-trunk scar skin repair combined with the external application of plasma on cytokines in wound surface in the patients with large area deep burn. Methods A total of 40 patients with grade In burns who were in burn and plastic surgery department in our hospital from January 2013 to January 2016 were enrolled in this study. According to the random number table, they were divided into the observation group and the control group, with each group of 20 cases. Post-trunk scar skins were selected for repair of scar surface in both groups, and on the basis of this, the observation group was given combined plasma application. The average healing rate and healing time, and the expression of epidermal growth factor （EGF） and tumor necrosis factor （TNF-α in wound surface in the two groups were observed. Results The healing rate in the observation group was higher than that in the control group at 7 d, 14 d and 21d after the treatment （P〈0.05）. The average healing time in the observation group was shorter than that in the control group （P〈0.05）. 40 patients who were given scar repair were observed, with the scar skin survival rate of 100%. There were 3 patients who were given skin repair twice at the same site in the post-trunk in the control group, and 2 patients who were given the skin repair for 3 times. There were no patients who were given skin repair for twice or more in the observation group. The expression of TNF-α in the observation group was lower than that in the control group （P〈0.05）, and the expression of EGF in the observation group was higher than that in the control group （P〈0.05） at 7 d, 14 d and 21 d after the treatment. In the course of treatment, adverse reactions were not observed in the two groups of patients. Conclusion The effects of postoperative repair of post-trunk scar skin repair combined with external plasma application are favorable, which can significantly shorten the healing period, and may play a role in regulating the expression of EGF and TNF-α on the wound surface, which is worthy of widespread clinical promotion.