牛碱性成纤维细胞生长因子联合脱细胞真皮基质修复深Ⅱ度烧伤创面的临床研究

Clinical Study on Bovine Basic Fibroblast Growth Factor Combined with Acellular Dermal Matrix for Repairing Deep Second Degree Burn Wounds

目的:观察牛碱性成纤维细胞生长因子联合脱细胞真皮基质(ADM)修复深Ⅱ度烧伤创面的临床效果。方法:选取九江市第一人民医院2023年1—12月收治的深Ⅱ度烧伤患者120例,根据随机数字表法分为A组、B组、C组,各40例。A组清创后外涂牛碱性成纤维细胞生长因子凝胶并覆盖ADM,B组清创后直接覆盖ADM,C组清创后仅外用牛碱性成纤维细胞生长因子凝胶。比较三组创面情况(创面愈合、创面容积、后期手术率)、瘢痕情况[温哥华瘢痕量表(VSS)、色素沉着发生率]、炎症因子[白细胞(WBC)计数、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6],并统计三组临床疗效、不良反应发生率。结果:创面完全愈合3个月后A组色素沉着发生率及治疗30 d后A组后期手术率均低于B组和C组,治疗7、14、21 d后创面容积均小于B组和C组,创面愈合均显著高于B组和C组(P<0.05);治疗21 d后,A组WBC、hs-CRP、IL-6水平均显著低于B组和C组(P<0.05);A组临床总有效率显著高于B组和C组(P<0.05);三组不良反应发生率比较,差异无统计学意义(χ^(2)=1.208,P=0.547)。结论:牛碱性成纤维细胞生长因子凝胶联合ADM修复深Ⅱ度烧伤创面的效果显著,对患者创面愈合、瘢痕情况、色素沉着及炎症因子均有积极改善作用,安全性较高。

Objective:To observe the clinical effect of Bovine Basic Fibroblast Growth Factor combined with acellular dermal matrix(ADM)in repairing wound surface of deep second degree burn.Method:A total of 120 patients with deep second degree burn treated in Jiujiang NO.1 People's Hospital from January to December 2023 were selected and divided into group A,group B and group C according to random number table method,40 cases in each group.Group A was coated with Bovine Basic Fibroblast Growth Factor Gel and ADM after debridement,group B was directly covered with ADM after debridement,and group C only Bovine Basic Fibroblast Growth Factor Gel was external applied after debridement.The wound condition(wound healing,wound volume and later surgery rate),scar condition[Vancouver scar scale(VSS),incidence of pigmentation],inflammatory factors[white blood cell(WBC)count,hypersensitive C reactive protein(hs-CRP)and interleukin-6(IL-6)]of three groups were compared,and the clinical efficacy and incidence of adverse reactions were counted.Result:The wound healed completely after 3 months,the incidence of pigmentation in group A,and the later surgery rate after 30 days of treatment in group A were lower than those in group B and group C,the wound volume after 7,14 and 21 days of treatment were lower than those in group B and group C,and the wound healing were significantly higher than those in group B and group C(P<0.05).After 21 d of treatment,the levels of WBC,hs-CRP and IL-6 in group A were significantly lower than those in group B and group C(P<0.05).The total clinical effective rate of group A was significantly higher than that of group B and group C(P<0.05).There was no significant difference in the incidence of adverse reactions among three groups(字2=1.208,P=0.547).Conclusion:Bovine Basic Fibroblast Growth Factor Gel combined with ADM has a significant effect in repairing wound surface of deep second degree burn,and has positive improve effects on wound healing,scar condition,pigmentation and inflammatory factors of patients,with high safety.Medical Innovation of China Vol.21,No.28 October,2024。