rbFGF、VSD结合局部氧疗对深Ⅱ度烧伤创面愈合及时长的影响

Healing efficacy and duration of recombinant bovine basic fibroblast growth factor,vacuum sealing drainage combined with local oxygen therapy in the treatment of deepⅡdegree burn wounds

目的探讨重组牛碱性成纤维细胞生长因子(recombinant bovine basic fibroblast growth factor,rbFGF)、封闭负压引流(vacuum sealing drainage,VSD)结合局部氧疗治疗深Ⅱ度烧伤创面的愈合效果及时长。方法自2018年1月至2019年4月,黄石市第五医院烧伤外科对就诊的92例深Ⅱ度烧伤患者采用随机双盲法分为对照组(46例)和观察组(46例)。对照组采用VSD结合局部氧疗进行治疗;观察组在对照组基础上增用rbFGF。并对两组临床疗效、恢复情况、氧环境、愈合后瘢痕情况以及并发症情况进行比较。结果观察组治疗总有效率高于对照组(P<0.05)。观察组创面愈合时间、换药次数、住院时间、愈合后瘢痕量表各维度评分均低于对照组。观察组治疗3周后创面愈合率、肉芽组织生长面积均高于对照组(P<0.05)。观察组乳酸脱氢酶(lactate dehydrogenase,LDH)水平低于对照组;琥珀酸脱氢酶(succinate dehydrogenase,SDH)水平高于对照组(P<0.05)。两组并发症总发生率比较,其差异无统计学意义(P>0.05)。结论采用rbFGF、VSD结合局部氧疗治疗深Ⅱ度烧伤可以改善创面组织的缺氧状态,促进创面愈合,缩短住院时间,并有助于减少愈合后瘢痕形成,且安全性较高,值得临床推广。

Objective To explore the healing efficacy and duration of recombinant bovine basic fibroblast growth factor(rbFGF),vacuum sealing drainage(VSD)combined with local oxygen therapy in the treatment of deepⅡdegree burn wounds.Methods From January 2018 to April 2019,92 patients with deepⅡdegree burn wounds in the Department of Burn Surgery of The Fifth Hospital of Huangshi were involved in this study.These patients were divided into control group(46 patients)and observation group(46 cases)according to randomized double-blind method.The VSD combined with local oxygen therapy was conducted in the control group and additional rbFGF on the basis of control group was conducted in the observation group.The clinical efficacy,recovery,oxygen environment,scar after healing and complications between two groups were compared.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The healing time,frequency of dressing change,length of hospital stay,scores of scar after healing of observation group were lower than those of the control group.The wound healing rate and granulation tissue growth area at 3 weeks after treatment of the observation group were higher than than those of control group(P<0.05).The level of lactate dehydrogenase(LDH)in the observation group was lower than that in the control group,and the succinate dehydrogenase(SDH)in the observation group was higher than that in the control group(P<0.05).There was no significant difference in total incidence of complications between two groups(P>0.05).Conclusion Application of rbFGF,VSD combined with local oxygen therapy in the treatment of deepⅡdegree burn wounds can improve the hypoxia state of wounds,promote wound healing,shorten the length of hospital stay,and help to reduce scar formation after healing.This method is safe and should be considerable for clinical promotion.