R-bFGF凝胶联合银离子敷料在手部外伤植皮患者供皮区的应用效果

Effect of recombinant bovine basic fibroblast growth factor gel combined with silver ion dressing on the donor site in patients with hand trauma undergoing skin grafting

目的探讨重组牛碱性成纤维细胞生长因子(R-bFGF)凝胶与银离子敷料对手部外伤植皮患者供皮区联合修复效果。方法选取丽水市中心医院2020年10月至2021年10月收治的行植皮治疗的手部外伤患者80例为研究对象,采用简单随机分组方法,按照1∶1的比例将研究对象分为对照组与观察组,每组40例。对照组采用常规凡士林纱布进行修复治疗,观察组采用R-bFGF凝胶联合银离子敷料进行治疗。治疗2周后评估两组患者修复效果,比较治疗前后两组患者心理弹性量表(CD-RISC)评分和视觉疼痛模拟评分(VAS)变化,对比两组患者创面愈合时间、肉芽组织生长时间、创面上皮形成时间以及换药次数等各项指标差异,观察两组手指总主动活动度(TAM)。结果观察组修复效果明显优于对照组(Z=4.92,P<0.05)。观察组手部功能恢复情况显著优于对照组(Z=4.31,P<0.05)。观察组CD-RISC评分[(77.54±11.35)分]显著高于对照组[(70.61±9.72)分](t=2.93,P<0.05),观察组VAS评分[(4.95±1.13)分]、创面愈合时间[(10.43±1.65)d]、肉芽组织生长时间[(7.42±2.35)d]、创面上皮形成时间[(10.25±2.47)d]和换药次数[(2.12±0.63)次]均显著低于、少于对照组[(5.52±1.24)分、(15.54±1.71)d、(11.56±2.71)d、(12.82±2.64)d、(3.35±0.86)次](t=-2.15、-13.60、-7.30、-4.50、-7.30,均P<0.05)。结论R-bFGF凝胶联合银离子敷料可有效提高手部外伤植皮患者供皮区的修复效果,改善其心理状态及疼痛感受,促进患者预后及功能恢复,对于手外伤患者的临床治疗具有较高的参考价值。

Objective To investigate the efficacy of combined repair therapy using recombinant bovine basic fibroblast growth factor(R-bFGF)gel and silver ion dressing on the donor site of patients with hand trauma undergoing skin grafting.Methods Eighty patients with hand trauma who underwent skin grafting at Lishui Central Hospital between October 2020 and October 2021 were enrolled in this study.Using a simple random grouping method,the patients were randomly assigned to a control group and an observation group in a 1:1 ratio,with 40 patients in each group.The control group received conventional vaseline gauze treatment,while the observation group was treated with a combination of R-bFGF gel and silver ion dressing.After 2 weeks of treatment,the repair effects of both groups were evaluated.Before and after treatment,the Connor-Davidson Resilience Scale(CD-RISC)scores and Visual Analog Scale(VAS)scores were compared between the control and observation groups.Additionally,wound healing time,granulation tissue growth time,wound epithelium formation time,and dressing change times as well as total active motion of the fingers were evaluated and compared between the two groups.Results The repair effect in the observation group was significantly superior to that in the control group(Z=4.92,P<0.05).Furthermore,the recovery of hand function in the observation group was notably better than that in the control group(Z=4.31,P<0.05).The CD-RISC score in the observation group was significantly higher than that in the control group[(77.54±11.35)points vs.(70.61±9.72)points,t=2.93,P<0.05].Additionally,the VAS score,wound healing time,granulation tissue growth time,wound epithelium formation time,and dressing change times in the observation group were significantly lower or fewer than those in the control group[(4.95±1.13)points vs.(5.52±1.24)points,(10.43±1.65)days vs.(15.54±1.71)days,(7.42±2.35)days vs.(11.56±2.71)days,(10.25±2.47)days vs.(12.82±2.64)days,and(2.12±0.63)times vs.(3.35±0.86)times,t=-2.15,-13.60,-7.30,-4.50,-7.30,all P<0.05].Conclusion The combined use of R-bFGF gel and silver ion dressing effectively enhances the repair outcomes of skin donor sites,thereby improving the psychological well-being and reducing pain perception in patients with hand trauma.This therapeutic approach markedly promotes the prognosis and functional recovery of these patients,offering valuable clinical reference for the treatment of hand injuries.