鼠神经生长因子联合腹部超薄皮瓣修复手部深度电烧伤创面

Application of Mouse Nerve Growth Factor Combined with Abdominal Ultra-thin Skin Flap Repair in the Treatment of Deep Electric Burn Wound of Hands

目的:观察鼠神经生长因子联合腹部超薄皮瓣修复术在手部深度电烧伤治疗中的临床效果。方法:选取2017年2月-2020年2月笔者医院收治的116例单纯手部深度电烧伤患者作为观察对象,根据非随机临床同期对照研究及患者自愿原则将其分为观察组(n=61)与对照组(n=55)。其中对照组使用腹部超薄皮瓣修复术,观察组在对照组基础上联合使用鼠神经生长因子。比较两组患者创面修复情况(皮瓣融合时间、皮瓣成活率及创面愈合时间),比较治疗前、治疗后2个月两组患者神经功能评分及神经传导速度,比较两组患者术后半年手功能(手部整体功能、掌指关节及近位指关节活动度)及生活质量[烧伤专用健康量表(Burn specific health scale-abbreviated,BSHS-A)水平情况。结果:两组皮瓣融合时间、皮瓣成活率及创面愈合时间比较差异均无统计学意义(P>0.05)。治疗后2个月,两组针刺觉、轻触觉及运动评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。两组感觉神经、运动神经传导速度较治疗前均明显加快,且观察组快于对照组,差异有统计学意义(P<0.05)。治疗后6个月,观察组手部整体功能优于对照组,掌指关节及近位指关节活动度大于对照组,且BSHS-A评分高于对照组,差异均有统计学意义(P<0.05)。结论:鼠神经生长因子联合腹部超薄皮瓣修复术治疗手部深度电烧伤创面效果良好,可改善患者神经传导速度及神经功能,促进手功能恢复,并能提高患者生活质量。

Objective To observe the clinical effect of mouse nerve growth factor combined with abdominal ultra-thin skin flap repair in the treatment of deep electric burns of the hands.Methods A total of 116 patients with simple deep electrical burns of hands who were admitted to the hospital between February 2017 and February 2020 were selected as observation subjects,and they were divided into the observation groups(n=61)and the control group(n=55)according to the non-randomized clinical concurrent controlled study and the principle of patient voluntariness.Patients in the control group received abdominal ultra-thin skin flap repair,and patients in the observation group were combined with mouse nerve growth factor on the basis of the control group.The wound repair status(skin flap fusion time,skin flap survival rate,wound healing time),neurological function scores and nerve conduction velocities before treatment and at 2 months after treatment,as well as hand function(overall hand function,ranges of motions of metacarpophalangeal joint and proximal finger joint)and quality of life[Burn specific health scale-abbreviated(BSHS-A)]at 6 months after treatment were compared between the two groups.Results There were no statistically significant differences in the skin flap fusion time,skin flap survival rate and systemic wound healing time between the two groups(P>0.05).At 2 months after treatment,the scores of acupuncture sensation,light touch and motor of the two groups were higher than those before treatment,and the scores of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).The sensory nerve and motor nerve conduction velocities of the two groups were significantly faster than those before treatment,and the velocities of the observation group were faster than those of the control group(P<0.05).At 6 months after treatment,the overall hand function of the observation group was better than that of the control group,and the ranges of motions of metacarpophalangeal joint and proximal finger joint were greater than those of the control group(P<0.05).The BSHS-A scores were higher in the observation group than those in the control group(P<0.05).Conclusion Mouse nerve growth factor combined with abdominal ultra-thin skin flap repair has a good application effect in repairing deep electric burn wounds of hands.It can improve the nerve conduction velocities and neurological function,promote the recovery of hand function,and improve the quality of life of patients.