MEBO联合VSD对骨科难愈性创面临床疗效及血清炎症因子水平的影响

目的对比观察湿润烧伤膏(moist exposed burn ointment,MEBO)联合负压封闭引流(vacuum sealing drainage,VSD)对骨科难愈性创面患者临床疗效及血清炎症因子水平的影响。方法选取2017年1月至2019年5月雷州骨科医院骨科收治的78例骨科难愈性创面患者作为研究对象,并按照随机数表法将其随机分为观察组与对照组,每组39例,其中观察组患者创面行MEBO联合VSD治疗,对照组患者创面单纯行MEBO治疗,对比两组患者创面愈合时间及治疗第7、14天时患者血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平。结果治疗第7天,两组患者血清IL-6、TNF-α及CRP水平均明显升高,且两组无明显差异(P均>0.05);而治疗第14天,两组患者血清IL-6、TNF-α及CRP水平均明显降低,且观察组患者均明显低于对照组(t=3.727、5.308、3.819,P均=0.000);观察组患者创面愈合时间明显短于对照组(t=3.597,P=0.001)。结论 MEBO联合VSD可有效促进骨科难愈性创面愈合,缩短创面愈合时间,且调节炎症因子水平可能是其部分作用机制,值得临床进一步深入探究。

Clinical Effect of MEBO Combined with VSD on Hard-to-healing Orthopedic Wounds and Their Influence on the Levels of Serum Inflammatory Factors

Objective To observe the clinical effect of moist exposed burn ointment(MEBO) combined with vacuum sealing drainage(VSD) on hard-to-healing orthopedic wounds and their influences on the levels of serum inflammatory factors.Methods Seventy-eight patients with hard-to-healing orthopedic wounds,admitted to the Department of Orthopedics,Leizhou Orthopedic Hospital from January 2017 to May 2019,were selected as research subjects and then divided,according to random number table,into an observation group(39 cases) and a control group(39 cases).The wounds of the patients in the observation group were treated with MEBO combined with VSD while the wounds of patients in the control group were treated with MEBO only.The wound healing time,and the levels of serum interleukin-6(IL-6),tumor necrosis factors-α(TNF-α) and C-reactive protein(CRP) on day 7 and day 14 of treatment were compared between the two groups.Results On day 7 of treatment,the levels of serum IL-6,TNF-α and CRP of the two groups increased significantly and no significant difference in their levels was observed between the two groups(all P> 0.05);on day 14 of treatment,the levels of serum IL-6,TNF-α and CRP reduced significantly,and their levels in patients of the observation group were significantly lower than the control group(t=3.727,5.308,3.819,all P=0.000);the wound healing time for the observation group was significantly shorter than the control group(t=3.597,P=0.001).Conclusion MEBO combined with VSD can promote the healing of hard-to-healing orthopedic wounds,thus shortening healing time.Its mechanism has something to do with regulation of the level of inflammatory factors,which needs further clinical research.