表皮细胞生长因子在吸入性损伤中的临床应用观察

目的:探讨表皮生长因子(Epidermal Growth Factor,EGF)在吸入性损伤中的临床应用效果。方法:收集2003年3月至2011年5月中山大学附属第一医院及惠东县人民医院住院82例重度烧伤合并吸入性损伤患者,随机分为治疗组和对照组,对照组38例,治疗组44例,对照组行支气管肺泡灌洗和超声雾化吸入,治疗组则于灌洗液中加入EGF,收集每次灌洗液蛋白含量(TP)、胶体渗透压(COP)、白蛋白(Alb)测定,同时行纤维支气管镜检查。结果:①治疗组中TP、COP、Alb均低于对照组,差别有统计学意义(P<0.01),且随着时间的推移治疗组各项指标较对照组差异愈加明显;②坏死粘膜脱落时间、气道分泌物量、肺部症状消失时间以及气管套管拔除时间指标,治疗组与对照组比较,差别均有显著统计学意义(P<0.01)。肺部感染发生率,治疗组与对照组比较,差别有统计学意义(P<0.05)。结论:EGF是治疗吸入性损伤安全、有效的药物,在修复损伤上皮细胞,减轻肺水肿,降低并发症等方面效果显著,值得在临床上推广应用。

Clinical Observation of Inhalation Injury Treated with Epidermal Growth Factor

Objective: To study the clinical effect of inhalation injury treated with epidermal growth factor.Method:There was a retrospective analysis of 82 patients with severe degree burn and inhalation injury of our hospital from March 2003 to May 2011,who were randomly assigned two groups,the control group 38 cases and the treatment group 44 cases.The control group patients were treated by broncho-alveolar lavage and ultrasonic atomizing inhalation,the treatment group were treated by the same methods,but EGF was additived in the bronchoalveolar lavage fluid.The changes of TP,Alb and COP in the irrigating solushion at different time were observed and flexible bronchofiberscope examination was used at the same time.Result: In comparison with the control group,①The TP,Alb and COP in the treatment group were decreased after treatment(P<0.01);②The time of mucosal necrosis,the amount of airway secretions,the time of disappearance of pulmonary inflammation and the time of tracheal tube removal in the treatment group were decreased after treatment(P<0.01).The incidence of lung infection in the treatment group were decreased after treatment(P<0.05).Conclusion: ECF is a safety and effective drug in treating inhalation injury,it can repair injured epithelial cells,abate pulmonary edema and reduce complication.It is worthy of clinical application.