标题：表皮细胞生长因子联合复方多黏菌素B对深Ⅱ度烧伤创面瘢痕的影响

      作者：陈泽春，李军，陈涛    安康市中心医院烧伤科，陕西 安康 725000

      卷次： 2019年30卷15期

      【摘要】 目的 探讨表皮细胞生长因子(rhEGF)联合复方多黏菌素 B对深Ⅱ度烧伤患者创面瘢痕的影响。方法 选择 2017年 1月至 2018年 1月安康市中心医院收治的 113例深Ⅱ度烧伤患者为研究对象，根据随机数表法分为观察组56例和对照组57例，所有患者均给予常规清创处理，对照组采用 rhEGF涂抹创面，观察组采用rhEGF联合复方多黏菌素B涂抹创面，两组疗程均为28 d。比较两组患者治疗后的创面愈合、细菌检出、瘢痕形成以及用药过程中不良反应情况。结果 观察组和对照组患者的深Ⅱ烧伤创面干燥时间[(6.51±2.62) d vs (9.62±3.51) d]、愈合时间[(19.52±3.73) d vs (25.85±5.95) d]、换药次数[(12.65±5.34)次 vs (17.51±6.72)次]比较，观察组均明显少于对照组，差异均有统计学意义(P<0.05)；观察组患者的创面愈合率为(95.26±2.37)%，明显高于对照组的(83.12±3.65)%，差异有统计学意义(P<0.05)；观察组患者用药后 7 d、14 d、28 d深Ⅱ烧伤创面病原菌检出率分别为 17.86%、12.50%、5.36%，均明显低于对照组的36.84%、28.07%、17.54%，差异均有统计学意义(P<0.05)；观察组和对照组患者的改良温哥华瘢痕评定量表(VSS)评分在用药后28 d [(7.25±2.16)分vs (8.66±2.54)分]、6个月[(5.38±1.94)分vs (7.03±2.11)分]、12个月[(3.25±1.02)分 vs (4.95±1.48)分]比较，观察组均低于对照组，差异均有统计学意义(P<0.05)；观察组患者的创面感染发生率为0，明显低于对照组的8.77%，差异有统计学意义(P<0.05)。结论 rhEGF联合复方多黏菌素B可促进深Ⅱ度烧伤创面愈合，降低创面感染，减少瘢痕组织形成。
      【关键词】 表皮细胞生长因子；复方多黏菌素B；深Ⅱ度烧伤；创面；瘢痕组织
      【中图分类号】 R644 【文献标识码】 A 【文章编号】 1003—6350（2019）15—1947—03

Effect of epidermal growth factor combined with compound polymyxin B on wound scar in patients with deepsecond degree burn.
CHEN Ze-chun, LI Jun, CHEN Tao. Department of Burns, Ankang Central Hospital, Ankang 725000,Shaanxi, CHINA
【Abstract】 Objective To investigate the effect of epidermal growth factor (rhEGF) combined with com-pound polymyxin B on scar formation in deep second degree burn wounds. Methods A total of 113 patients of deepsecond degree burn in Ankang Central Hospital from January 2017 to January 2018 were selected as the research ob-jects. They were divided into observation group and control group according to random number table method. Basedon routine debridement, 57 patients were treated with rhEGF (control group), and 56 patients were treated with rhEGFand compound polymyxin B (observation group). Both groups were treated for 28 days. The differences of wound heal-ing, bacterial detection, scar formation, and adverse reactions between the two groups before and after treatment werecompared. Results Compared with the control group, the drying time, healing time, dressing change times in the obser-vation group were significantly lower than those in the control group (P<0.05): (6.51±2.62) d vs (9.62±3.51) d, (19.52±3.73) d vs (25.85±5.95) d, (12.65±5.34) times vs (17.51±6.72) times. The wound healing rate of the observation groupwas (95.26±2.37)%, which was significantly higher than (83.12±3.65)% of the control group (P<0.05). The detectionrates of pathogenic bacteria in the wounds in the observation group were 17.86%, 12.50%, and 5.36% at 7 days, 14 days,and 28 days after treatment, respectively, which were significantly lower than 36.84%, 28.07%, and 17.54% in the con-trol group (P<0.05). The scores of the improved Vancouver Scar Scale (VSS) in the observation group and the controlgroup were lower than those in the control group at 28 days, 6 months, 12 months (P<0.05): (7.25±2.16) vs (8.66±2.54),(5.38±1.94) vs (7.03±2.11), (3.25±1.02) vs (4.95±1.48), respectively. Conclusion rhEGF combined with compoundpolymyxin B can promote wound healing, reduce wound infection and scar formation in deep second degree burns.
      【Key words】 Epidermal growth factor; Compound polymyxin B; Deep second degree burn; Wound; Scar tissue