摘要
目的通过临床对比研究,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,rhGMCSF)凝胶剂对深Ⅱ度烧伤创面溶痂及愈合的作用及其机制。方法以2008年12月-2010年12月收治的符合选择标准的58例深Ⅱ度烧伤患者作为试验对象。男36例,女22例;年龄12～67岁,平均32.4岁。热液烫伤38例,火焰烧伤20例。受伤至治疗时间为1～3d,平均2.1d。采用随机双盲、自身对照方法,分为给予rhGMCSF凝胶剂治疗组(试验组)及不含rhGMCSF的凝胶剂基质治疗组(对照组)。两组用药面积比较差异无统计学意义(P>0.05),具有可比性。用药后观察创面情况,于2、6、10、14、18d计算创面溶痂率,记录完全溶痂时间及创面愈合时间。结果与对照组相比,试验组用药4d后黄白色坏死组织或痂皮逐渐变软;6d后坏死组织易浮动而脱落或痂皮边缘翘起,基底红白相间,深层肉芽组织增长迅速;8d时痂皮基本溶解。用药2d后试验组创面溶痂率即高于对照组,除用药后18d,其余各时间点两组创面溶痂率比较差异均有统计学意义(P<0.05)。试验组完全溶痂时间为(7.71±2.76)d,较对照组(14.71±3.63)d明显缩短(t=13.726,P=0.000);创面愈合时间为(18.41±2.47)d,亦较对照组(23.58±3.35)d明显缩短(t=15.763,P=0.000)。结论 rhGMCSF凝胶剂与单纯凝胶剂基质相比能促进深Ⅱ度烧伤创面坏死组织脱落,加快创面愈合。
Objective To investigate the effectiveness and mechanism of recombinant human granulocyte-macrophage colony-stimulating factor（rhGMCSF） gel on wound debridement and healing of deep II thickness burn.Methods Between December 2008 and December 2010,58 patients with deep II thickness burn,accorded with the inclusive criteria,were collected.There were 36 males and 22 females with an average age of 32.4 years（range,12-67 years）.The causes were hot liquid in 38 cases and fire in 20 cases.The time from injury to treatment was 1-3 days（mean,2.1 days）.In this randomized,double-blind,and self-control study,all patients were randomly divided into 2 groups,wounds were treated with rhGMCSF gel（test group） or gel matrix（control group）.There was no significant difference in wound area between 2 groups（P 〉 0.05）.The time of completed removal eschar and the percentage of removal-area of eschar were recorded at 2,6,10,14,and 18 days during healing process.The time of wound healing was also recorded.Results Compared with control group,the necrotic tissues on the burn wound got soft in test group at 4 days after treatment.At 6 days,they loosened and eventually sloughed off.The wound bed presented in red and white,followed by rapidly growing granulation tissues.Except 18 days after treatment,there were significant differences in the percentage of removal-area of eschar between 2 groups（P 〈 0.05）.The time of completed removal eschar in test group [（7.71 ± 2.76） days] was significantly shorter than that in control group [（14.71 ± 3.63） days]（t=13.726,P=0.000）.The time of wound healing in test group was（18.41 ± 2.47） days,which was significantly shorter than that in control group [（23.58 ± 3.35） days]（t=15.763,P=0.000）.Conclusion Compared with the gel matrix,the rhGMCSF gel may promote wound debridement and healing in deep II thickness burn
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第9期1059-1062,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
重组人粒细胞巨噬细胞集落刺激因子
深Ⅱ度创面
创面溶痂
创面愈合
Recombinant human granulocyte-macrophage colony-stimulating factor Deep II thickness burn Wound debridement Wound healing
