rhGM-CSF凝胶联合磺胺嘧啶银对面部深Ⅱ度烧伤创面愈合质量的影响

Effect of rhGM-CSF gel Combined with Silver Sulfadiazine on Healing Quality of Facial Deep Second-degree Burns

目的:探讨重组人粒细胞巨噬细胞集落刺激因子(Recombinant human granulocyte macrophage colony stimulating factor,rhGM-CSF)联合磺胺嘧啶银治疗面部深Ⅱ度烧伤的疗效。方法:选择2016年6月-2021年11月笔者医院收治的96例面部深Ⅱ度烧伤患者,采用随机数表法分为观察组和对照组各48例,对照组给予磺胺嘧啶银霜治疗,观察组给予磺胺嘧啶银霜+rhGM-CSF凝胶治疗,比较两组创面愈合相关指标及美学效果。结果:观察组创面结痂时间、痂皮基本溶解时间及创面完全愈合时间均短于对照组(P<0.05),治疗后各时间点疼痛评分均低于对照组(P<0.05);治疗后,两组创面细菌培养阳性率均降低,但组间比较差异无统计学意义(P>0.05);治疗后1、2周,两组血清血管内皮生长因子(Vascular endothelial growth factor,VEGF)、表皮生长因子(Epidermal growth factor,EGF)、转化生长因子β1(Transforming growth factor-β1,TGF-β1)水平均高于治疗前,且观察组高于对照组(P<0.05);治疗3周后,观察组创面美学效果各评分及总分均明显高于对照组(P<0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论:对面部深Ⅱ度烧伤患者采用rhGM-CSF凝胶与磺胺嘧啶银联合治疗,可有效促进患者创面愈合、降低疼痛程度,提高血管生长因子水平,美学效果好,值得在临床推广应用。

Objective The purpose of this study was to investigate the effect of recombinant human granulocyte/macrophage colony stimulating factor(rhGM-CSF)combined with silver sulfadiazine in patients with facial deep second-degree burns.Methods A total of 96 patients with deep partial-thickness facial burns admitted to the author's hospital from June 2016 to November 2021 were selected and divided into observation group and control group according to the random number table method,with 48 cases in each group.The control group was treated with silver sulfadiazine cream,and the observation group was treated with silver sulfadiazine cream+rhGM-CSF gel.The wound healing related indicators and aesthetic effects of the two groups were compared.Results Observation group wound scab over time,time of basic dissolved scab skin and wound healed completely time is shorter than the control group(P<0.05),pain score at each time point after treatment were lower than that of control group(P<0.05);After treatment,the positive rate of wound bacterial culture in the two groups decreased,but there was no significant difference between the two groups(P>0.05).1,2 weeks after treatment,two groups of serum Vascular endothelial growth factor(VEGF)and Epidermal growth factor(EGF),Transforming growth factor beta-β1(TGF-β1)levels were higher than before the treatment,and the observation group is higher than the control group(P<0.05);3 weeks after treatment,the observation group wound aesthetic effect the score and total score were significantly higher than that of control group(P<0.05);There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion rhGM-CSF gel combined with silver sulfadiazine in the treatment of patients with deep partial thickness burns on face can effectively promote wound healing,reduce pain,improve the level of vascular growth factor,and has good aesthetic effect,which is worthy of clinical application.