重组人酸性成纤维细胞生长因子治疗肛瘘术后创面的随机对照试验

目的：观察重组人酸性成纤维细胞生长因子（rh-aFGF）对肛瘘术后的创面促愈合作用.方法：237例肛瘘术后患者随机分为2组,观察组（n=125）给予rh-aFGF,对照组（n=112）给予重组人碱性成纤维细胞生长因子（bFGF）进行创面治疗.观察治疗3周后两组剩余创面大小、愈合率、创面祛腐时间、创面平均愈合时间、创面愈合率、肉芽生长开始时间等情况,及治疗后第7、14、21天肉芽组织生长、创面疼痛情况.结果：治疗3周后,观察组在减少创面面积,增强创面愈合率,缩短愈合时间、祛腐时间,以及肉芽组织开始生长时间等方面均优于对照组（P＜0.05或0.01）;治疗后第7天两组肉芽组织生长情况及疼痛情况差异无统计学意义（P＞0.05）,治疗第14天及第21天,两组肉芽组织生长及疼痛差异均有统计学意义（P＜0.05）.结论：rh-aFGF对肛瘘术后的促修复作用较bFGF更强,有效促进创面缩小、缩短祛腐时间与愈合时间、缩短肉芽生长开始时间、提高创面愈合率、有效提高肉芽组织生长、缓解创面疼痛等方面的作用.

Effect of Recombinant Human Acidic Fibroblast Growth Factor in Promoting Wound Healing after Anal Fistula Surgery by Randomized Controlled Trials

Objective：To study the effect of recombinant human acidic fibroblast growth factor （rh-aFGF） in promoting wound healing after anal fistula surgery.Methods：Totally 237 cases of patients were randomly divided into two groups,the treatment group （n =125,treated with rh-aFGF） and the control group （n =112,treated with bFGF）.The wound area reduction,wound healing rate,wound recovering time,the time of corruption elimination and granulation growth were recorded and compared after the 3-week treatment.And the granulation growth and wound pain on the 7th,14th and 21st day of the treatment were described.Results：After the 3-week treatment respectively by rh-aFGF and bFGF,the wound area was （0.3 ± 0.3）cm2 vs （1.1 ± 0.9）cm2（P 〈 0.01）,the wound healing rate was 90.3% vs 78.6% （P 〈 0.05）,the time of healing was （16.2 ± 3.2） d vs （20.3 ± 5.6） d （P 〈 0.01）,the time of corruption eliminate was （2.2 ± 0.2） d vs （3.4 ± 1.1） d （P 〈 0.05）,the time of granulation growth was （2.3 ± 0.8） d vs （4.1 ± 1.3）d（P 〈0.01）.On the 7th day after the treatment,there were no significant differences（P 〉 0.05） in the growth of granulation tissue and wound pain,however,on the 14th and 21st day after the treatment,there were significant differences（P 〈0.05） in the two indices.Conclusion：Rh-aFGF is more effective than bFGF in promoting wound healing of anal fistula surgery.Rh-aFGF can effectively promote the wound healing and the healing rate,shorten the time of wound recovering and granulation growth,alleviate the wound pain and enhance the granulation tissue growth.