重组人表皮生长因子凝胶在肛门区域手术后难愈合创面的应用效果研究

Study on the application effect of recombinant human epidermal growth factor gel on difficult healing wounds after anal surgery

目的比较重组人表皮生长因子凝胶(rhEGF)和康复新液外用在肛门区域手术后难愈合创面的应用效果。方法选取2017年5月~2019年12月我院肛肠科肛门直肠良性疾病手术后难愈合创面患者45例进行回顾性研究,患者自愿选择分配到rhEGF组或康复新组。观察指标为用药前、用药后3 d、7 d及14 d的创面面积、愈合时间、创面分泌物评分、创面毛细血管含量,以及有无创面过敏红肿、周围皮肤发生湿疹、糜烂、渗出及瘙痒等不良反应。结果用药前、用药3 d和7 d时,两组创面面积变化情况比较,差异无统计学意义(P>0.05);用药第14天rhEGF组创面毛细血管含量增多,创面面积小于康复新组(P<0.05),愈合时间短于康复新组,创面分泌物评分高于康复新组(P<0.05)。手术4周后统计rhEGF组平均愈合时间为(14.30±2.74)d,短于康复新组的(17.21±3.67)d,差异有统计学意义(P<0.05)。康复新组有2例出现创面周围皮肤湿疹、瘙痒,经对症处理好转。结论康复新液和rhEGF均含有生长因子,可以促进伤口愈合,但在机制、时机和效果上存在差异。rhEGF的主要作用是促进上皮的再上皮化及促进中期或后期愈合伤口。

Objective To compare the efficacy of recombinant human epidermal growth factor gel(rhEGF)and Kangfuxin fluid in refractory wounds of the anal area after surgery.Methods A total of 45 patients with refractory wounds after surgery for anorectal benign disease in the Department of Proctology in our hospital from May 2017 to December 2019 were retrospectively analyzed.The patients were voluntarily assigned to rhEGF group or Kangfuxin group.The wound surface area before and 3,7 and 14 days,healing time,wound secretions scores and wound capillary contents healing time after administration were observed.The adverse reactions including the presence of wound allergy,redness,eczema,erosion,exudation and pruritus on the surrounding skin were observed.Results There was no statistically significant difference in the wound area of the two groups before,3 days and 7 days after medication(P>0.05).On the 14th day of medication,the capillary content of the wound in rhEGF group increased,and the wound area was smaller than that of the Kangfuxin group,healing time was shorter than that of the kangfuxin group,the wound secretion score of rhEGF group was higher than that of the Kangfuxin group(P<0.05).Four weeks after surgery,the average healing time was(14.30±2.74)days in rhEGF group shorter than(17.21±3.67)days in the Kangfuxin group.The difference between the two groups was significant(P<0.05).There were 2 cases of eczema and itchy skin around the wound in the Kangfuxin group.Symptoms were improved after treatment.Conclusion Both rhEGF and Kangfuxin contain growth factors,which can promote wound healing,but there are differences in mechanism,timing and effect.The main role of rhEGF is to promote re-epithelialization of the epithelium,and promote intermediate or late wound healing.