摘要
目的探讨下肢慢性溃疡创面网状植皮术后应用重组人表皮生长因子闭合灌洗联合封闭负压引流技术的临床疗效。方法回顾性分析安徽医科大学解放军第一七四临床学院烧伤整形科2013年1月至2014年6月收治的45例慢性溃疡患者临床资料。所有患者均行手术清创并网状自体皮片移植术,术后行闭合灌洗并封闭负压引流技术,根据灌洗液的种类分为2组,治疗组(23例)采用浓度为6×105IU/L人表皮生长因子灌洗液;对照组(22例)采用0.9%氯化钠溶液作为灌洗液。观察2组患者的皮片成活率、创面愈合时间、术后14 d疼痛情况和愈合后6个月瘢痕情况。结果与对照组相比,治疗组植皮皮片存活率高(t=9.347,P<0.01),溃疡创面愈合时间短(t=4.561,P<0.01),植皮术后14 d疼痛评分较低(t=6.804,P<0.01),术后6个月瘢痕评分低(t=6.005,P<0.01)。结论下肢慢性溃疡创面网状植皮术后应用重组人表皮生长因子闭合灌洗联合封闭负压引流技术可减少患者疼痛,减轻瘢痕增生,提高愈合质量,临床疗效确切,值得推广。
Objective To investigate the clinical effect of mesh skin autograft combined with VSD technique and continuous recombinant human epidermal growth factor （rh-EGF） irrigation in the treatment of chronic ulcer wound on the lower limbs. Methods From January 2013 to June 2014,retrospective review the 45 patients with lower limb chronic ulcer which were underwent debridement combined with VSD technique postoperation and mesh skin autograft. According to the irrigated solution＇s species, we randomly divided them into two groups：the treatment group （23 cases）used continuous rh-EGF irrigation applied with the concentration of 6×10^5IU/L combined with VSD technique after mesh skin autograft, while the control group used 0.9% normal saline. Then observe the take rate of mesh skin of treatment, the wound healing time, the painful degree 14days postoperation and ulcer wound scar after healing for lyear. Results Compared with control group ,the take rate of mesh skin of treatment is higher（ t =9. 347, P 〈0.01 ） ,the wound healing time is shorter（t =4. 561, P 〈0.01 ）, the visual analog pain score（VAS） after skin grafting, vancouver scar scale for 6 months postoperation of treatment group was lower （ t = 6. 005, P 〈 O. 01 ）. Conclusion Mesh skin autograft combined with VSD technique and continuous rh-EGF irrigation in the treatment of chronic ulcer wound on the lower limbs can decrease distress and hyperplasia of the scar from the patients, improve the healing quality, the clinical results, it is significantly effective and the method deserves to be popularized.
出处
《中华损伤与修复杂志（电子版）》
CAS
2015年第4期34-37,共4页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
国家自然科学基金(81372050)
关键词
负压伤口疗法
表皮生长因子
皮肤溃疡
皮肤移植
Negative- pressure wound therapy
Epidermal growth factor
Skin ulcer
Skin transplantation
