改性甲壳素联合重组人碱性成纤维细胞生长因子治疗浅Ⅱ度烧伤创面的临床观察

目的观察改性甲壳素联合重组人碱性成纤维细胞生长因子(rh-bFGF)在治疗浅Ⅱ度烧伤创面的治疗效果。 方法将石家庄市第一医院烧伤整形科2015年11月至2017年8月收治的80例浅Ⅱ度烧伤患者按随机数字表法分为治疗组和对照组，每组40例。治疗组患者创面先外用rh-bFGF喷洒，再用改性甲壳素生物修复膜覆盖，常规预防感染治疗，每天换药1次，直至创面愈合；对照组清理创面后，外用改性甲壳素生物修复膜覆盖创面，每日换药1次。观察两组患者平均创面愈合时间、患者伤后7、10、13 d创面愈合率、创面感染情况、瘢痕情况、患者换药疼痛指数及其他不良反应。患者创面平均愈合时间及不同时间点烧伤创面愈合率、患者换药疼痛指数比较均采用t检验。 结果治疗组患者创面平均愈合时间(11.55±2.02) d，较对照组(12.63±1.96) d]明显缩短，差异均有统计学意义(t＝2.41，P＝0.02)；治疗组伤后7、10、13 d创面愈合率分别为(86.00±4.28)%、(95.53±3.65)%和(99.55±0.68)%，明显高于对照组(84.23±3.38)%、(93.50±3.21)%和(99.10±1.06)%]，差异均有统计学意义(t＝2.06、2.63、2.27，P＝0.04、0.01、0.03)；治疗组患者换药疼痛数字评分法(NRS)评分为(3.46±0.51)分，对照组患者换药疼痛NRS评分为(3.50±0.50)分，两组比较差异无统计学意义(t＝0.27，P＝0.78)。治疗过程两组均未出现感染患者，随访3个月均未出现瘢痕增生；未发现其他不良反应。 结论应用改性甲壳素联合rh-bFGF能明显缩短浅Ⅱ度烧伤患者创面愈合时间，提高创面愈合率，未见其他不良反应。

Clinical observation of modified chitin combined with recombinant human basic fibrolast growth factor in treating superficial partial-thickness burn wound

ObjectiveTo observe the therapeutic effect of modified chitin combined recombinant human basic fibrolast grouth factor (rh-bFGF) on superficial partial-thickness burn wounds. MethodsEighty cases of Superficial partial-thickness burns from the department of Burns and Plastic Surgery, First Hospital of Shijiazhuang from November 2015 to August 2017 were divided into the treatment group and the control group according to the random number table method, 40 cases in each group. The treatment group patients′ wounds were first sprayed with rh-bFGF, then covered with modified chitin, and routinely prevented infection treatment. The dressing was changed once a day until the wounds healed. After cleaned the wounds of control group, externally modified chitin was used to cover the wounds and the dressing was changed once a day. The average wound healing time, wound healing rates of patients on 7, 10 and 13 days after injury, wound infection status, scar condition, patient dressing pain index, and other adverse reactions were observed. The t-test was used to compare the average wound healing time, the healing rates of wounds at different time, and the patient′s dressing pain index. ResultsThe average healing time in the treatment group was (11.55±2.02)d, which was shorter than the (12.63±1.96) d]of control group, the difference was statistically significant (t=2.41, P=0.02). The healing rates in the treatment group at 7, 10, 13 days were (86.00±4.28)%, (95.53±3.65)% and (99.55±0.68)%, those were higher than the control group(84.23±3.38)%, (93.50±3.21)% and (99.10±1.06)%], the differences were statistically significant (t=2.06, 2.63, 2.27; P=0.04, 0.01, 0.03). The numerical rating score (NRS) of patients in the treatment group was (3.46±0.51) points, and in the control group was (3.50±0.50) points, there was no statistically significant difference (t=0.27, P=0.78). No infection occurred in both groups during the treatment, and no scar hyperplasia was observed in the follow-up 3 months. No other adverse reactions were found. ConclusionThe use of modified chitin combined with rh-bFGF can significantly shorten the wound healing time and increase the wound healing rate in patients with superficial second degree burns, and no other adverse reactions were found.