重组人粒细胞巨噬细胞集落刺激因子凝胶与脱细胞异种皮治疗深Ⅱ度烧伤创面的临床效果比较

摘要

Objective To investigate the effects of recombinant human granulocyte macrophage colony stimulating factor gel and the clini-cal effect of acellular xenogeneic skin for treating deep second degree burn wounds. Methods Between 2010 January 2013 to January in our hos-pital,deep second degree burn patients in 60 cases,using a random number table method patients were divided into three groups and were recor-ded as a group treated with rhGM CSF therapy),group B(given off acellular skin treatment)and group C treated with traditional methods of treat-ment),20 cases in each group. The 7,14,21 days of wound healing,7 days of wound bacteria detection rate,scar score were observed. Results A,B two groups compared to the C group,wound healing rate of 7,14,21 days is improved significantly,healing time significantly is lower, and the difference is statistically significant( P < 0. 01). A group and B group was compared. The wound healing rate at 7,14 and 21 days also significantly improved,at the same time,healing time significantly is lower,and the difference is statistically significant( P < 0. 01). A and C groups compared with B group,the bacterial detection rate at 7 days,had no significant difference(all P > 0. 05). Between a group and C group, the bacterial detection rate at 7 days significantly decreased( P < 0. 01). Compared with group C,softness,thickness and vascularity four aspects of A and B two groups in color were significantly reduced,the difference is statistically significant( P < 0. 01). The flexibility,thickness and vas-cular distribution also remarkably is lower,and the difference is statistically significant( P < 0. 05). Conclusion In the early stage of deep sec-ond degree burn wound healing,rhGM CSF gel with acellular xenogeneic skin treatment has good cure rate,each with its different advantages.%目的：比较重组人粒细胞巨噬细胞集落刺激因子（rhGM - CSF）凝胶与脱细胞异种皮治疗深Ⅱ度烧伤创面的临床效果，为治疗Ⅱ度烧伤提供临床参考。方法2010年1月至2013年1月收治的深Ⅱ度烧伤患者60例，采用随机数表法将患者分为三组，分别计为 A 组（给予 rhGM - CSF 治疗），B 组（给予脱细胞异种皮治疗），C 组（给予传统方法治疗），每组20例。观察第7、14、21天的创面愈合情况、7 d 创面细菌检出率、瘢痕评分。结果与 C 组比较，A、B 两组第7、14、21天创面愈合率有显著性的提高，愈合时间有显著性的降低，差异有统计学意义（均 P <0.01）；与 B 组相比，A组第7、14、21天创面愈合率也有显著性的提高，同时愈合时间有显著性的降低（均 P <0.01）。三组7 d 细菌检出率均无显著性差异（均 P >0.05）；而与 C 组对比，A 组7 d 细菌检出率有显著性的降低（ P <0.01）。A、B 两组在色泽、柔软度、厚度、血管分布等4个方面较 C 组显著降低（均 P <0.01）；与 B 组比较，A 组在柔软度、厚度、血管分布等4个方面也有显著性的降低（均 P <0.05）。结论在深Ⅱ度烧伤的创伤修复早期阶段，rhGM - CSF 凝胶与脱细胞异种皮治疗都具有良好的治愈率，各具有其不同的优势。