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1、削痂术后应用rh-aFGF治疗深II度烧伤的临床研究【摘要】目的探讨深II度烧伤创面伤后48h内削痂联合重组人酸性成纤维细胞生长因子(rh-aFGF)与重组碱性成纤维细胞生长因子(bFGF)促进创曲愈合的临床效果与安全性。方法选择烧伤总面积在15%〜40%,以深II度为主的住院患者69例在伤后48h内削痂,治疗组39例削痂后给予rh-aFGF治疗,对照组30例给予bFGF治疗,观察创面愈合及并发症发生情况。结果rh-aFGF治疗后,治疗组完全愈合时间、12d愈合率、15d愈合率分别为(14.7±4.3)d、84.6%、94.8%;对照组分别为(18.6±3.7)d、
2、56.6%、73.3%0两组比较差异具有统计学意义(P〈0.05)。另外治疗组水肿评分,感染评分分别为(1.4±0.3)分,(1.2±0.4)分。皮片边缘坏死发生率为5.2%,皮片存活面积为(98.4±2.3)%。对照组则分别为(2.8±0.7)分,(2.7±0.8)分,26.7%,(91.4±3.6)%0两组比较差异具有统计学意义(1X0.05)。结论rh-aFGF促进创面愈合在降低并发症发生程度方血相比于bFGF更优。【关键词】重组人酸性成纤维细胞生长因子;削痂术;深II度烧伤【Abstract】ObjectiveToexploretheclinicaleffe
3、ctandsecurityofpromotionofwoundhealingbyrecombinanthumanacidicfibroblastgrowthfactor(rh-aFGF)andrecombinant,basicfibroblast,growthfactor(bFGF)combinedwithparingscabinthetreatmentofthedeepIIdegreeburnwoundinjurywithin48h.MethodsAtotalof79caseswithburnarearangingfrom15%to40%,ofdeepIIdegr
4、eewithin48hourswereselected・Therewere39casesinthetreatmentgroupgivenrh-aFGFtreatment,afterparingscab,andthe30casesinthecontrolgroupweregivenbFGFtreatmentafterparingscab・Thewoundhealingandcomplicationswereobserved・ResultsAftertherh-aFGFtreatment,thetotalhealingtime,healingrateafter12day
5、sand15dayswere(14・7±4・3)d,84.6%,and94.8%.Thoseofthecontrolgroupwere(1&6+3.7)d,56.6%,73.3%・Differencesofthetwogroupshadstatisticalsignificance(P<0・05)・Additionally,theedemascores,infectionscore,andskinnecrosisincidenceofthetreatmentgroupwere(1.4±0.3)points,(1.2±0.4)points,and5.2%,andthe
6、edgeofflapsurvivalareawas(98.4±2.3)%・Thoseofthecontrolgroupwere(2.8+0.7)points,(2.7±0.8)points,26.7%,and(91.4±3.6)%.Differencesbetweenthetwogroupswerestatisticallysignificant(P<0.05).ConclusionApplyingrh-aFGFinpromotingwoundhealinghaslowerdegreeofcomplicationsthanbFGF.【Keywords]Humanre
7、combinantacidicfibroblastgrowthfactor;卩aringscabtechnique;DeepTTdegreeburn深II度烧伤创面由于其坏死组织的持续存在,经常会引起创面局部过强的炎症反应,导致感染和局部组织的进行性损害,从而影响创面的愈合进程[1]。有学者研究,深II度烧伤创面进行性损害常发生在伤后48h内。削痂术后去除坏死组织可防止进行性感染发生,但肉芽组织的生长并未加快[2],成纤维细胞生长因子(FGF)已被证实具有修复表皮、真皮、肌肉、脂肪、神经及血管内皮细胞等作用,可加快创面愈合,减少创面处并发症[3],但rh-aFG