rbFGF联合脱细胞异体真皮和自体超薄皮片复合移植修复大面积烧伤创面

Effects of rbFGF Combined with Acellular Allogeneic Dermis and Autologous Ultrathin Skin Composite Graft in Repairing Deep Wounds of Extensive Burns

目的:探讨重组碱性成纤维细胞生长因子(Recombinant basic fibroblast growth factor,rbFGF)+脱细胞异体真皮+自体超薄皮片复合移植修复大面积烧伤深部创面的效果。方法:回顾性分析2017年10月-2020年10月在笔者医院进行治疗的116例大面积烧伤患者一般临床资料,根据患者治疗方式进行分组,将采用rbFGF+自体超薄皮片修复者纳入对照组(n=55),将采用rbFGF+脱细胞异体真皮+自体超薄皮片复合移植修复者纳入实验组(n=61),探讨不同治疗方式对患者深部创面的影响。结果:两组创面愈合后疗效比较差异无统计学意义(95.08%vs 90.91%,P>0.05),但实验组肉芽生长评分明显高于对照组,创面无渗出液时间、结痂时间、创面愈合时间、住院时间均明显短于对照组,差异有统计学意义(P<0.05)。治疗后实验组色泽、柔软度、厚度、血管分布评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子(TNF-α)水平均显著降低,且实验组均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组血管内皮生长因子(VEGF)、表皮细胞生长因子(EGF)水平均显著升高,且实验组均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组琥珀酸脱氢酶(SDH)、组织液氧分压水平均显著升高,乳酸脱氢酶(LDH)降低,且实验组治疗后SDH、组织液氧分压水平明显高于对照组,LDH低于对照组,差异有统计学意义(P<0.05)。结论:rbFGF+脱细胞异体真皮+自体超薄皮片复合移植在修复大面积烧伤深部创面中应用较佳,创面修复效果良好,抗炎效果较佳,可有效促进肉芽组织生长成熟,缩短创面愈合时间,值得在临床推广应用。

Objective This research aims to investigate the effects of recombinant basic fibroblast growth factor combined with acellular allogeneic dermis and autologous ultra-thin skin composite graft in repairing deep wounds of extensive burns.Methods The general clinical data of 116 patients with extensive burns treated in the hospital from October 2017 to October 2020 were retrospectively analyzed.According to the treatment method,the patients were divided into the control group(rbFGF+autologous ultra-thin skin repair,n=55)and the experimental group(rbFGF+acellular allogeneic dermis+autologous ultra-thin skin composite graft,n=61).Effect of different treatment methods on deep wounds was discussed.Results There was no significant difference in curative effect between the two groups(95.08%vs 90.91%,P>0.05).The granulation growth score of the experimental group was significantly higher than that of the control group,and the time of no exudation,scab formation,wound healing and hospital stay in the experimental group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).After treatment,the scores of color,softness,thickness and vascular distribution in the experimental group were significantly lower than those in the control group(P<0.05).After treatment,hs-CRP,IL-6 and TNF-αwere detected in the two groups,and the levels in the experimental group were significantly lower than those in the control group(P<0.05).After treatment,the levels of VEGF and EGF increased significantly in two groups,the levels o in the experimental group were significantly higher than those in the control group(P<0.05).After treatment,the levels of SDH and tissue liquid oxygen partial pressure increased significantly and LDH decreased in the two groups(P<0.05).After treatment,the levels of SDH and tissue liquid oxygen partial pressure in the experimental group were significantly higher than those in the control group and LDH was lower than those in the control group(P<0.05).Conclusion Applying combined with acellular allogeneic dermis and autologous ultra-thin skin composite graft in repairing deep wounds of extensive burns can achieve good repairing effects,and the anti-inflammatory effect is better.It can effectively promote the growth and maturity of granulation.