摘要
目的评价脱氧核苷酸钠干预创面愈合的临床疗效。方法纳入144例II类切口以上的患者，按随机数字表法分为2组，每组72例。对照组于术后给予常规药物外敷、抗生素、补液、葡萄糖滴注常规治疗，同时给予胸腺五肽1mg／次，1次／d，溶于5％葡萄糖溶液或生理盐水中滴注。观察组则在常规治疗基础上给予脱氧核苷酸钠200mg／次，1次／d。于第7、14、30天评价创面的愈合情况。结果两组术后感染发生率比较差异无统计学意义（12．1％VS16．6％，P〉0．05）。观察组患者较对照组具有更高的14d完全愈合率（80％VS48．3％，P〈0．05）、体重增加量[（2．1±0．7）kgvs（0．6±0．3）kg，P=0．016）]、临床总有效率（89．3％VS61．3％，P=0．0018），具有更少的7d遗留创面面积[（12．6±6．8）cm^2VS（18．7±7．1）cm^2 ，P=0．018]和更短的创面安全愈合时间[（18．8±11．2）dVS（21．4±12．6）d，P=0．023]。治疗后观察组III型前胶原水平明显高于对照组[（35．4±7．6）ng／LVS（24．4±6．9）ng／L，P=0．006）。结论脱氧核苷酸与胸腺五肽均能通过激活免疫，减少术后感染，但创面愈合修复与免疫提升似乎并无关联，脱氧核苷酸可通过促进成纤维细胞增殖及肉芽组织生长、迁移促进创伤的愈合。
Objective To evaluate the efficacy and safety of deoxyribonucleotide in intervention with wound healing. Methods A total of 144 patients above Type II incision was included. All patients were received conventional therapy. And 72 cases in positive group were given thymopentin lmg/d for 7 - 14 days, 72 patients in treatment group were given deoxyribonucleotide 200mg/d for 7 - 14 days. Wounds were observed at 7, 14, 30 days, respectively. Results Postoperative infection rate（ 12. 1% vs 16. 6% vs 40% , P 〈 0. 05 ） , pathogenic bacteria detection were decreased by both treatment and control groups. The 14 d complete healing rate（ 80% vs 48.3%, P 〈 0. 05 ）, weight gain[ （ 2. 1 ± 0.7 ） kg vs （ 0. 6 ± 0. 3 ） kg, P =0. 016] , clinical effect （89.3% vs 61.3% , P =0. 0018） of treatment group were higher than the control group. The 7 d wound area and complete healing time of treatment group were lower than the control group [ （12. 6 ±6. 8）cm2 vs （18. 7 ±7.1）cm2, P =0. 018;（18. 8 ±11.2）d vs （21.4 ±12. 6）d, P =0. 023]. Deoxyribonueleotide can promote fibroblast proliferation and collagen production [ （35.4 ±7.6 ）ng/L vs （ 24. 4 ±6. 9 ） ng/L, P = 0. 006 ]. Conclusions Short-term application of deoxyribonueleotide and thymo- pentin can decrease postoperative infection through activating immune function. However, wound healing had no relationship with activating immune function seemly. Deoxyribonueleotide promotes wound healing through promoting fibroblast proliferation.
出处
《中国医师杂志》
CAS
2013年第9期1202-1205,共4页
Journal of Chinese Physician
关键词
核苷酸类
治疗应用
钠
伤口愈合
烧伤
外科伤口感染
药物疗法
Nucleotides/therapeutie use
Sodium
Wound healing
Bums
Surgical wound infec- tion/drug therapy
