MEBT/MEBO治疗合并感染难愈合创面的疗效

Efficacy of MEBT/MEBO in treating coinfected refractory wounds

目的探讨皮肤再生医疗技术(湿润暴露烧伤疗法/湿润烧伤膏,MEBT/MEBO)治疗合并感染难愈合创面的疗效及对外周血内皮细胞生长因子(VEGF)、白细胞介素-4(IL-4)、IL-13及T淋巴细胞亚群的影响。方法选择2019年1月-2020年12月右江民族医学院附属医院收治的合并感染难愈合创面患者86例,随机分为研究组与对照组。对照组创面处外敷两层生理盐水纱布及两层消毒干纱布,研究组创面处涂抹MEBO后外敷两层生理盐水纱布及两层消毒干纱布。比较两组创面愈合情况,分析治疗前和治疗后3、7、14 d外周血VEGF、IL-4、IL-13及T淋巴细胞亚群水平变化。采用受试者工作特征(ROC)曲线分析上述指标对创面愈合的预测价值。结果研究组愈合情况优于对照组(Z=-2.280,P=0.023)。治疗后3、7、14 d,研究组VEGF、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均高于对照组(P<0.05),IL-4、IL-13、CD_(8)^(+)均低于对照组(P<0.05)。ROC曲线分析显示,治疗后3 d各指标对创面愈合不良均有较高的预测价值,联合检测的ROC曲线下面积(AUC)为0.904(95%CI:0.824~0.983)。结论MEBT/MEBO治疗合并感染难愈合创面有更好的疗效,可更好降低创面炎症反应,增加创面免疫功能,促进肉芽组织增生及创面愈合,此外治疗后3 d多种指标联合对创面愈合有较好的预测价值。

OBJECTIVE To investigate the effect of skin regeneration therapy(MEBT/MEBO,MEBT/MEBO)on refractory wounds complicated with infection and the effects on peripheral blood endothelial growth factor(VEGF),interleukin-4(IL-4),IL-13 and T lymphocyte subsets.METHODS A total of 86 patients who were admitted of Affiliated Hospital of Youjiang Medical College for Nationalities from Jan 2019 to Dec 2020 and suffered from complicated infection and difficult-to-heal wound surface were recruited and randomly divided into the study group and control group.The wound surface of the control group was externally applied with two layers of saline and two layers of sterile dry gauze,while the wound surface of the research group was externally applied with two layers of saline and two layers of sterile dry gauze after MEBO was applied.The wound healing in both groups was compared,and the levels of VEGF,IL-4,IL-13 and T lymphocyte subsets in peripheral blood were analyzed before and after the 3 rd,7 th and 14 th day of the treatment.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the above indexes on wound healing.RESULTS The wound healing in the treatment group was superior to that in the control group(Z=-2.280,P=0.023).On day 3,7 and 14 after treatment,VEGF,CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) in the study group were significantly higher than those in the control group(P<0.05),while IL-4,IL-13 and CD_(8)^(+) were significantly lower than those in the control group(P<0.05).ROC curve analysis showed that all indexes had high predictive value for wound healing 3 days after treatment,and the area under ROC curve(AUC)of combined detection was 0.904(95%CI:0.824-0.983).CONCLUSION MEBT/MEBO has better clinical efficacy in the treatment of refractory wounds complicated with infection,which could better reduce wound inflammation,increase wound immune function,promote granulation tissue hyperplasia and wound healing.In addition,the combination of multiple indexes 3 days after treatment had better predictive value for wound healing.