表皮细胞生长因子联合复方多黏菌素B对深Ⅱ度烧伤创面瘢痕的影响

Effect of epidermal growth factor combined with compound polymyxin B on wound scar in patients with deep second degree burn

目的探讨表皮细胞生长因子(rhEGF)联合复方多黏菌素B对深Ⅱ度烧伤患者创面瘢痕的影响。方法选择2017年1月至2018年1月安康市中心医院收治的113例深Ⅱ度烧伤患者为研究对象,根据随机数表法分为观察组56例和对照组57例,所有患者均给予常规清创处理,对照组采用rhEGF涂抹创面,观察组采用rhEGF联合复方多黏菌素B涂抹创面,两组疗程均为28d。比较两组患者治疗后的创面愈合、细菌检出、瘢痕形成以及用药过程中不良反应情况。结果观察组和对照组患者的深Ⅱ烧伤创面干燥时间[(6.51±2.62)dvs(9.62±3.51)d]、愈合时间[(19.52±3.73)dvs(25.85±5.95)d]、换药次数[(12.65±5.34)次vs(17.51±6.72)次]比较,观察组均明显少于对照组,差异均有统计学意义(P<0.05);观察组患者的创面愈合率为(95.26±2.37)%,明显高于对照组的(83.12±3.65)%,差异有统计学意义(P<0.05);观察组患者用药后7d、14d、28d深Ⅱ烧伤创面病原菌检出率分别为17.86%、12.50%、5.36%,均明显低于对照组的36.84%、28.07%、17.54%,差异均有统计学意义(P<0.05);观察组和对照组患者的改良温哥华瘢痕评定量表(VSS)评分在用药后28d[(7.25±2.16)分vs(8.66±2.54)分]、6个月[(5.38±1.94)分vs(7.03±2.11)分]、12个月[(3.25±1.02)分vs(4.95±1.48)分]比较,观察组均低于对照组,差异均有统计学意义(P<0.05);观察组患者的创面感染发生率为0,明显低于对照组的8.77%,差异有统计学意义(P<0.05)。结论rhEGF联合复方多黏菌素B可促进深Ⅱ度烧伤创面愈合,降低创面感染,减少瘢痕组织形成。

Objective To investigate the effect of epidermal growth factor (rhEGF) combined with compound polymyxin B on scar formation in deep second degree burn wounds.Methods A total of 113 patients of deep second degree burn in Ankang Central Hospital from January 2017 to January 2018 were selected as the research objects. They were divided into observation group and control group according to random number table method.Based on routine debridement, 57 patients were treated with rhEGF (control group), and 56 patients were treated with rhEGF and compound polymyxin B (observation group).Both groups were treated for 28 days.The differences of wound healing, bacterial detection, scar formation, and adverse reactions between the two groups before and after treatment were compared.Results Compared with the control group, the drying time, healing time, dressing change times in the observation group were significantly lower than those in the control group (P<0.05):(6.51±2.62) d vs (9.62±3.51) d,(19.52± 3.73) d vs (25.85±5.95) d,(12.65±5.34) times vs (17.51±6.72) times.The wound healing rate of the observation group was (95.26±2.37)%, which was significantly higher than (83.12±3.65)% of the control group (P<0.05).The detection rates of pathogenic bacteria in the wounds in the observation group were 17.86%, 12.50%, and 5.36% at 7 days, 14 days, and 28 days after treatment, respectively, which were significantly lower than 36.84%, 28.07%, and 17.54% in the control group (P<0.05).The scores of the improved Vancouver Scar Scale (VSS) in the observation group and the control group were lower than those in the control group at 28 days, 6 months, 12 months (P<0.05):(7.25±2.16) vs (8.66±2.54),(5.38±1.94) vs (7.03±2.11),(3.25±1.02) vs (4.95±1.48), respectively.Conclusion rhEGF combined with compound polymyxin B can promote wound healing, reduce wound infection and scar formation in deep second degree burns.