重组人酸性成纤维细胞生长因子对剖宫产妇女腹部切口愈合影响的临床研究

目的 评价不同给药方式的重组人酸性成纤维细胞生长因子（rh-aFGF）对剖宫产妇女腹部切口愈合的近期影响及瘢痕形成的远期影响.方法 入选5 16例剖宫产妇女,按随机数字表法分为安慰剂组、喷雾组和冲洗组,每组172例,安慰剂组术后给予0.9％氯化钠冲洗腹部切口后缝合;喷雾组于切口缝合后直接给予rh-aFGF喷雾,3～4喷/cm2,3～5次/d;冲洗组术中腹壁缝合前给予2支rh-aFGF溶于0.9％氯化钠直接冲洗后缝合切口,然后给予喷雾治疗.近期随访15d观察产妇腹部切口愈合情况,远期随访3个月观察切口瘢痕形成情况.结果 冲洗组腹部切口完全愈合时间为（8.6±3.5）d,较喷雾组的（10.4±3.7）d及安慰剂组的（12.7±4.9）d均明显缩短,差异有统计学意义（P＜0.05）;冲洗组延迟愈合占4.2％（7/166）,显著低于安慰剂组的20.2％（34/168）及喷雾组的9.7％（16/165）,差异有统计学意义（P＜0.05）;三组脂肪液化、术后感染发生率比较差异无统计学意义（P＞0.05）;冲洗组渗出、腹壁粘连发生率低于安慰剂组和喷雾组2.4％（4/166）比10.1％（17/168）、5.5％（9/165）,3.6％（6/166）比17.3％（29/168）、9.7％（16/165）],差异有统计学意义（P＜0.05）.远期随访发现,冲洗组瘢痕面积比喷雾组减少13.5％,比安慰剂组减少27.2％.结论 rh-aFGF近期可缩短剖宫产产妇腹部切口愈合时间以及减少腹壁粘连及渗出;rh-aFGF的最佳给药方式为术中冲洗联合术后喷雾进行治疗.

Clinical research of recombinant human acidic fibroblast growth factor in cesarean section women abdominal incision healing

Objective To evaluate the recent impact and long-term effects of recombinant human acidic fibroblast growth factor （rh-aFGF） of cesarean section on women＇s abdominal incision healing.Methods In 516 cases of cesarean section in women,randomly divided into placebo group （172 cases）,spray group （172 cases） and flush group （172 cases）.The placebo group received 0.9% sodium chloride washing abdominal incision suture.The spray group incision suture direcdy after the administration of rh-aFGF spray,per square meter of 3-4 sprays,3-5 times/d.The flush group was given before 2 rh-aFGF dissolved in 10-20 ml of 0.9% sodium chloride directly after washing the incision suture,then given spray treatment.The recent follow-up of 15 d observed maternal abdominal incision healing.Long term follow-up of 3 months to observe the incision scar formation.Results The abdominal incision heating time was （8.6 ±3.5） d,that was obviously shorter than that in spray group （10.4 ±3.7） d and placebo group （12.7 ± 4.9） d （P 〈 0.05）.The delay healing accounted for 4.2% （7/166） in flush group,significantly lower than that in placebo group （34/168,20.2%） and spray group （16/165,9.7%） （P〈 0.05）.There was no significant difference in the incidence of fat liquefaction,postoperative infection among three groups （P 〉 0.05）.Flush group exudation,abdominal wall adhesions was lower than placebo group and spray group 2.4%（4/166） vs.10.1%（17/168）,5.5%（9/165）,3.6%（6/166） vs.17.3%（29/168）,9.7%（16/165）]（P〈0.05）.Long term follow-up,flush group scar area than spray group reduced by 13.5%,than placebo group reduced by 27.2%.Conclusions A recent rh-aFGF can reduce the cesarean section abdominal incision healing time and reduce abdominal wall adhesions and exudation;rh-aFGF the best dosage is intraoperative irrigation treatment spray combined with postoperative.