重组人粒细胞-巨噬细胞集落刺激因子促进皮肤软组织撕脱伤创面修复效果临床观察

目的 观察重组人粒细胞-巨噬细胞集落刺激因子促进皮肤软组织撕脱伤创面修复的临床效果.方法 对2010年4月-2014年6月急诊收治的74例皮肤软组织撕脱伤患者进行回顾性分析,按临床治疗特征将其分为观察组和对照组,各37例.两组均给予基础治疗,对照组采用单用纳米银敷料对创面给予换药治疗.观察组采用注射用重组人粒细胞-巨噬细胞集落刺激因子涂抹创面,再用纳米银敷料进行创面换药,两组患者均至创面完全愈合后停止治疗.观察两组愈合情况及细菌检出率,并评估其安全性.结果 治疗第3、6和8天,观察组创面愈合率均高于对照组,创面炎症评分均低于对照组(P ＜0.001).两组治疗第3、6和8天创面炎症评分均低于治疗前(P＜0.05).观察组治疗期间细菌检出率和平均创面愈合时间均低于对照组(P＜0.05,P＜0.001).两组治疗后主要肝肾功能指标比较差异均无统计学意义(P＞0.05).结论 重组人粒细胞-巨噬细胞集落刺激因子治疗皮肤软组织撕脱伤安全有效,可对创面的修复起到积极促进的作用,能明显的减轻炎性反应.

Effect Observation of rhGM-CSF in Promoting Avulsed Wound Repair of Skin and Soft Tissues

Objective To investigate clinical effect of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) in promoting avulsed wound repair of skin and soft tissues.Methods Clinical data of 74 patients with avulsed wound of skin and soft tissues admitted during April 2010 and June 2014 was retrospectively analyzed,and the patients were divided into observation group and control group (n =37 for each group) according to different treatment methods.All patients were given basic treatment,control group was given nano-Ag dressing for wound surface,while observation group was smeared wound surface with rhGM-CSF injection,and then given nano-Ag dressing.The therapy was discontinued when the wound had healed completely in two groups.Healing conditions and bacteria detection rates were observed,and safety was evaluated in two groups.Results At the 3rd,6th and 8thd of treatment,wound healing rate was significantly higher,while wound inflammation score was significantly lower in observation group than those in control group (P ＜ 0.001).At the Td,6th and 8th d of treatment,wound inflammation scores were significantly lower than those before treatment in two groups (P ＜0.05).During treatment,values of bacterial detection rate and average wound healing time in observation group were significantly lower than those in control group (P ＜ 0.05,P ＜ 0.001).There were no significant differences in liver and kidney function indexes after treatment between two groups (P ＞ 0.05).Conclusion RhGM-CSF is effective in treatment of avulsed wound of skin and soft tissues,and it can obviously promote wound repair and relieve inflammation reaction.