高明龍+彭文方+程志華+程小平

[摘要]目的 觀察富林蜜與外用重組人粒細(xì)胞-巨噬細(xì)胞刺激因子凝膠治療深Ⅱ燒傷的臨床療效。方法 選取2016年5月～2017年5月我院收治的深Ⅱ度燒傷患者103例為研究對(duì)象，按計(jì)算機(jī)產(chǎn)生的隨機(jī)數(shù)并依據(jù)奇偶數(shù)分為對(duì)照組51例，觀察組52例。對(duì)照組和觀察組分別在創(chuàng)面涂抹重組人粒細(xì)胞-巨噬細(xì)胞刺激因子凝膠基礎(chǔ)上外敷磺胺嘧啶銀霜和富林蜜紗布，觀察兩組的創(chuàng)面愈合率、愈合時(shí)間、細(xì)菌培養(yǎng)和不良反應(yīng)等指標(biāo)。結(jié)果 兩組愈合率隨時(shí)間增長(zhǎng)均有增加，但觀察組的愈合率高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），觀察組的平均愈合時(shí)間為（24.5±3.8）d，低于對(duì)照組的（29.6±4.7）d。1周內(nèi)兩組細(xì)菌培養(yǎng)陽性率差異不大，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），未見明顯皮膚不良反應(yīng)和肝腎功能異常。結(jié)論 富林蜜與外用重組人粒細(xì)胞-巨噬細(xì)胞刺激因子凝膠聯(lián)合應(yīng)用治療深Ⅱ度燒傷的臨床效果顯著，值得在臨床上推廣。

[關(guān)鍵詞]燒傷；創(chuàng)面愈合；富林蜜；重組人粒細(xì)胞-巨噬細(xì)胞刺激因子凝膠

[中圖分類號(hào)] R644 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2017）09（c）-0018-03

[Abstract]Objective To observe the clinical efficacy of Flamigel combined with external recombinant human granulocyte- macrophage stimulating factor gel on treating level Ⅱ deep burn.Methods From May 2016 to May 2017，103 patients with level Ⅱ deep burn treated in our hospital were selected as research objects.By odd or even numbers and computerized randomization，they were divided into control group （n=51） and observation group （n=52）.Besides smearing recombinant human granulocyte-macrophage stimulating factor gel on the wound，external application of sulfadiazine silver cream and Flamigel gauze was used in the control group and observation group respectively.The wound healing rate，healingtime，bacterialculture，and adverse reaction were observed in both groups.Results With the time prolonging，the healing rate in the two groups was increased，but the rate in the observation group was higher （P<0.05）.The average healing time was （24.5±3.8） d in the observation group，shorter than that in the control group，（29.6±4.7）d.There was no significant difference in the positivity rate of bacterial culture within one week between the two groups （P>0.05）.No obvious adverse reactions of the skin or abnormal liver and kidney functions was displayed.Conclusion Combination of Flamigel andexternal recombinant human granulocyte-macrophage stimulating factor gel can obtain a remarkable effect on treating level Ⅱ deep burn，which is worthy of promotion in clinic.

[Key words]Burn；Wound healing；Flamigel；Recombinant human granulocyte-macrophage stimulating factor gel

研究顯示深Ⅱ燒傷是臨床需要進(jìn)行早期治療的一類，一般不能自愈[1]，可因感染、水腫和過度的炎性反應(yīng)使創(chuàng)面進(jìn)一步發(fā)生惡化，容易發(fā)展為Ⅲ燒傷，失去通過保守治療而達(dá)到愈合的機(jī)會(huì)，最終需要手術(shù)治療[2]。對(duì)深Ⅱ燒傷采取有效治療措施是關(guān)鍵。理想燒傷的治療藥物是既能抵擋外來細(xì)菌的感染，又能為內(nèi)部創(chuàng)傷面的恢復(fù)提供好的環(huán)境，快速有效地促進(jìn)創(chuàng)面的愈合[3]。本研究通過觀察富林蜜與外用重組人粒細(xì)胞-巨噬細(xì)胞刺激因子凝膠（rhGM-CSF）聯(lián)合應(yīng)用治療深Ⅱ燒傷的臨床效果，為其臨床應(yīng)用提供科學(xué)依據(jù)，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

選取2016年5月～2017年5月我院收治的深Ⅱ度燒傷患者103例為研究對(duì)象。納入標(biāo)準(zhǔn)為肢體部位燒傷，面積達(dá)10%～30%總體表面積（TBSA），傷后24 h內(nèi)就醫(yī)，并未做其他治療，由2位主治醫(yī)師聯(lián)合診斷完成。燒傷類型主要是火焰或熱氣熱液燒傷。排除標(biāo)準(zhǔn)：手足部位燒傷；合并嚴(yán)重心腦血管疾病、糖尿病、肝腎功能不全；哺乳期婦女或孕婦及相關(guān)藥物過敏者。由計(jì)算機(jī)產(chǎn)生的隨機(jī)數(shù)并依據(jù)奇偶數(shù)分為對(duì)照組和觀察組。對(duì)照組51例，觀察組52例。對(duì)照組平均年齡（35.6±9.8）歲，男女比例為26/25。觀察組平均年齡（36.8±10.3）歲，男女比例為27/25。兩組患者的年齡、性別、燒傷部位差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。本研究經(jīng)醫(yī)院醫(yī)學(xué)倫理委員會(huì)批準(zhǔn)，患者均知情同意。endprint