MEBT/MEBO联合ADSC治疗慢性难愈合创面的疗效分析

Efficacy Analysis of MEBT/MEBO Combined ADSC in the Treatment of Chronic Refractory Wounds

目的分析烧伤创疡再生医疗技术(MEBT/MEBO)联合脂肪十细胞(ADSC)治疗慢性难愈合创面的临床疗效方法选取2017年1月至2020年1月龙岩市第一医院收治的61例慢性难愈合创面患者作为研究对象,并按照随机数表法将其随机分为研究组(31例)与对照组(30例),研究组患者局部创面采用MEBT/MEBO联合ADSC治疗,对照组患者局部创面采用MEBT/MEBO治疗,对比两组患者临床疗效,创面组织中血管内皮生长因子(VEGF)及碱性成纤维细胞生长因子(bFGF)表达水平,创面愈合时间以及愈后皮肤瘢痕增生情况。结果治疗4周后.研究组患者中显效17例、有效11例、尤效3例,明显优于对照组患者中显效10例、有效11例、无效9例(Z=-2.070,P=0.038):两组患者创面组织中VECF、bFGF表达水平均明显升高,且研究组患者明显高于对照组(t=3.431、2.138,P=0.001、0.036);最终两组患者创面均完全愈合,研究组患者创面愈合时间明显短于对照组(t=2.740,P=0.008),愈后皮肤温哥华瘢痕量表(VSS)评分明显低于对照组(t=3.405,P=0.001)。结论MEBT/MEBO联合ADSC可显著提高慢性难愈合创面组织中VEGF、bFGF表达水平,缩短创面愈合时间,减轻愈后皮肤瘢痕增生,提高临床疗效。

Objective To observe the clinical efficacy of Moist Exposed Burn Therapy/Moist Exposed Burn Ointment(MEBT/MEBO)combined with adipose-derived stem cell(ADSC)in the treatment of chronic efractory wounds.Methods 61 patients with chronic refractory wounds,admitted into Longyan First Hospital from January 2017 to January2020,were enrolled and divided into study group(n=31)and control group(n=30)using random number table.The local wounds of patients in study group were treated with MEBT/MEBO plus ADSC,while the control group were treated with MEBT/MEBO only.The clinical efficacy,expression level of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF),wound healing time and the status of scar hyperplasia of the healed skin were compared between the two groups.Results After 4 weeks of treatment,in study group,17 cases were markedly effective,11 cases were effective and 3 cases were ineffective,which was significantly better than control group(Z=-2.070,P=0.038)in which 10 cases were markedly effective,11 cases were effective and 9 cases were ineffective.The expression levels of VEGF and bFGF in the wound tissues of both groups were all elevated markedly,and they were significantly higher in study group than control group(t=3.431 and 2.138,P=0.001 and 0.036).In the end,the local wounds in both groups were all healed completely,and the healing time in study group was obviously shorter than control group(t=2.740,P=0.008),and the Vancouver scar scale(VSS)score of the healed skin in study group was also markedly lower than control group(t=3.405,P=0.001).Conclusion The combined application of MEBT/MEBO and ADSC can markedly elevate the expression levels of VEGF and bFGF,shorten wound healing time,ameliorate scar hyperplasia,and improve the clinical efficacy in the treatment of chronic refractory wounds.