自体富血小板凝胶结合封闭负压引流对深Ⅱ度烧伤患者创面愈合进程及EGF、bFGF水平的影响

Effects of autologous APG combined with VSD on wound healing process and levels of EGF and bFGF in patients with deep second-degree burns

摘要:

目的 探讨自体富血小板凝胶（APG）结合封闭负压引流（VSD）对深Ⅱ度烧伤患者创面愈合进程及表皮生长因子（EGF）、碱性成纤维细胞生长因子（bFGF）水平的影响。方法 选取2018年7月—2021年7月在南通大学附属南通第三医院就诊的82例深Ⅱ度烧伤患者作为研究对象，按随机数字表法分为观察组（APG结合VSD治疗）和对照组（VSD治疗），各41例。比较两组患者的疗效、创面愈合时间、肉芽生长面积、创面愈合率、住院时间、并发症，比较两组患者治疗前后的EGF、bFGF、C反应蛋白（CRP）、白细胞介素6（IL-6）、白细胞计数（WBC）、疼痛视觉模拟评分（VAS）的差值及治疗后1个月、2个月的温哥华瘢痕量表（VSS）评分的差值。结果 观察组总有效率高于对照组（P <0.05）。观察组创面愈合时间、住院时间少于对照组，肉芽生长面积大于对照组，创面愈合率高于对照组（P <0.05）。观察组治疗前后EGF、bFGF、CRP、IL-6、WBC的差值高于对照组（P <0.05）。观察组治疗前与治疗后14 d VAS评分及治疗后1个月与2个月VSS评分的差值高于对照组（P <0.05）。两组患者并发症总发生率比较，差异无统计学意义（P >0.05）。结论 APG结合VSD治疗深Ⅱ度烧伤可加快患者创面愈合进程，提高EGF、bFGF水平，减轻炎症反应和疼痛，减少瘢痕增生，且并发症少。

Abstract:

Objective To investigate the effects of autologous platelet-rich gel (APG) combined with vacuum sealing drainage (VSD) on wound healing process and levels of epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) in patients with deep second-degree burns.Methods Eighty-two patients with deep second-degree burns treated in Nantong Third Hospital Affiliated to Nantong University from July 2018 to July 2021 were selected and included in the study. They were randomly divided into observation group (APG combined with VSD treatment) and control group (VSD treatment) via random number table method, with 41 cases in each group. The therapeutic efficacy, time to wound healing, area of granulation, wound healing rate, length of hospital stay, and incidence of complications were compared between the two groups. The differences of the levels of EGF, bFGF, C-reactive protein (CRP), and interleukin-6 (IL-6), white blood cell count (WBC), and Visual Analogue Scale (VAS) scores before and after the treatment, and those of Vancouver Scar Scale (VSS) scores 1 month and 2 months after the treatment were compared between the two groups.Results The overall effective rate of the observation group was higher than that of the control group (P < 0.05). Compared with the control group, the time to wound healing and length of hospital stay were shorter, the area of granulation was larger, and the wound healing rate was higher in the observation group (P < 0.05). The differences of the levels of EGF, bFGF, CRP and IL-6, and of WBC before and after the treatment in the observation group were higher than those in the control group (P < 0.05). The difference of VAS scores before and 14 days after the treatment and that of VSS scores 1 month and 2 months after the treatment in the observation group were higher than those in the control group (P < 0.05). There was no significant difference in the overall incidence of complications between the two groups (P >0.05).Conclusions For treating deep second-degree burns, APG combined with VSD accelerates the wound healing process, increases the levels of EGF and bFGF, mitigates inflammation and pain, and reduces hypertrophic scars with few complications.