复合皮移植技术对烧伤后大面积瘢痕患者血清EGF和TNF-α的影响

Curative Efficacy of Composite Skin Grafting Technique in Treatment of Extensive Scarring after Burnsand Its Effectson Serum EGF and TNF-α

目的:探讨复合皮移植技术对烧伤后大面积瘢痕患者血清表皮细胞生长因子(Epidermal Growth Factor,EGF)和肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)的影响。方法:选择2015年2月-2017年2月于笔者医院进行治疗的烧伤后大面积瘢痕患者60例为研究对象,随机分为观察组(n=33)和对照组(n=27)。观察组采用复合皮移植技术进行治疗,对照组采用反复切取后躯干瘢痕皮进行治疗。比较两组患者疗效、治疗前后EGF和TNF-α水平、创面愈合时间、疼痛程度、住院时间及不良反应发生情况。结果:治疗后,两组患者总有效率分别为96.97%、70.37%,差异有统计学意义(P<0.05);两组患者治疗前EGF、TNF-α水平无明显差异;治疗后,两组患者EGF、TNF-α水平均明显改善,且观察组EGF水平明显高于对照组,TNF-α水平显著低于对照组(P<0.05);观察组患者创面愈合时间、疼痛程度及住院时间均明显低于对照组(P<0.05);两组患者不良反应总发生率分别为9.09%、29.63%,差异有统计学意义(P<0.05)。结论:烧伤后大面积瘢痕患者应用复合皮移植技术安全有效,可以有效促进创面愈合,改善EGF和TNF-α水平,值得临床推广应用。

Objective To study curative efficacy of composite skin grafting technique in treatment of extensive scarring after burnsand its effectson serum epidermal cell growth factor(EGF) and tumor necrosis TNF-α. Methods 60 cases of large area scar after burn admitted to our hospital were selected as the research object, from February 2015 to February 2017, randomly divided into observation group(n=33) and control group(n=27). The observation group was treated with composite skin grafting technology, and the control group was treated with repeated excision of scar skin on the trunk. efficacy, EGF, TNF-α levels, wound healing time, pain degree, length of hospital stay and adverse reactions before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the two groups was 96.97% and 70.37%, respectively, with statistically significant difference(P<0.05). There was no significant difference in EGF and TNF-α levels between the two groups before treatment. After treatment, EGF and TNF-α levels in both groups were significantly improved, and EGF levels in the observation group were significantly higher than those in the control group, while TNF-α levels were significantly lower than those in the control group(P<0.05). The wound healing time, pain degree and hospitalization time in the observation group were significantly lower than those in the control group(P<0.05). The total incidence of adverse reactions in the two groups was 9.09% and 29.63%, respectively(P<0.05). Conclusion The application of composite skin transplantation technique to large area scar after burn can effectively promote wound healing, improve EGF and TNF-α levels, and reduce complications, which is worthy of clinical application.