表皮细胞生长因子和碱性成纤维细胞生长因子促进烧伤创面愈合的疗效比较

目的　比较外源性重组人表皮细胞生长因子 (rhEGF)与重组人碱性成纤维细胞生长因子 (rhFGF)促进创面愈合的临床疗效。方法　选择浅Ⅱ度烧伤创面、深Ⅱ度烧伤创面和刃厚皮供皮区创面共 90例患者 2 70个创面为研究对象 ,所有创面分别为rhEGF治疗组、rhFGF治疗组和自身对照组 ,选择自体相应部位、相似深度创面进行对照。分别观察创面愈合时间和在不同时间内创面的愈合率。结果　rhEGF的促再上皮化作用明显 ,对浅Ⅱ度烧伤创面及刃厚皮供皮区创面比rhFGF组和对照组愈合时间缩短 (P <0 .0 1) ,rhEGF对深Ⅱ度烧伤创面与对照组愈合时间无明显差异 (P >0 .0 5 ) ;而rhFGF对肉芽组织生长有特殊的作用 ,rbFGF对深Ⅱ度烧伤创面比rhEGF组和对照组愈合时间明显缩短 (P <0 .0 1) ,对浅Ⅱ度烧伤创面及刃厚皮供皮区创面比对照组愈合时间无明显差异 (P >0 .0 5 ) ;动态愈合率在不同的烧伤创面也明显加快 ,组间具有显著性差异。结论　rhEGF和rhFGF修复创面效果的差异取决于它们不同的生物学特性以及作用机制 ,组织缺损较大 ,组织损伤层次深 ,早期需要内芽组织填充的创面使用rhFGF为宜 ,而浅度创面需要以再上皮化修复为主的则选择rhEGF为佳

Comparision of the Wound Healing Acceleration of Recombinant Human Epidermal Growth Factor and Recombinant Human Fibroblast Growth Factor in the Treatment of Burn Wounds

Objective To evaluate acceleration of recombinant human epidermal growth factor(rhEGF)and recombinant human fibroblast growth factor(rhFGF) in the treatment of burn wounds. Methods A total of 270 wounds in 90 patients was enrolled in this study.Superfical Ⅱdegree burn wounds( n =90), profoundⅡdegree burn wounds ( n =90)and Skin offering wounds( n =90), 270 cases were treated with rhEGF,rhFGF or the control group.The self corresponding wounds with same depth in all patients were used as controls.The healing time and healing rates in different time were observed.Results The resulte showed that wound healing was accelerated in the shallow wounds and skin offering wounds treated with rhEGF than that rhFGF group and the control group ( P <0.01),In rhEGF group,the velocity of re epithelialization was faster than that rhFGF group and the control group. In deepⅡdegree burn wounds,the healing time showed no significant between rhEGFgroup and the controls ( P >0.05). The healing time of the profound Ⅱdegree burn wounds treated with rhFGF than the rhEGF and the controls ( P <0.01),new granulation tissue in rhFGF was more than that of rhEGF group.In superficialⅡ°burn wounds and Skin offering wounds the healing time showed no significant difference between rhFGF group and the controls ( P >0.05);The dynamic healing rates were obviously increased in different wouds, and they are significantly different in groups.Conclusion The results indicate thet rhEGF and rhFGF can stimulate wound healing,however, the mechanisms and the biological effects involved in these processes are quite different. It suggests that it is better to use rhFGF in those deep burn wounds which need more granulation tissue formation and use rhEGF in the shallow wounds which mainly need re epithelialization.