华若岳

[摘要]目的：探讨重组人表皮生长因子（recombinant human epidermal growth factor，rhEGF）在面部深Ⅱ度烧伤创面修复过程中的应用效果。方法：2016年6月-2018年1月笔者医院收治的面部皮肤深Ⅱ度烧伤患者100例作为研究对象，采用随机数表法分为观察组和对照组。对照组采用常规治疗，观察组在对照组的基础上使用rhEGF治疗。对比两组创面愈合时间、6个月后温哥华瘢痕量表（Vancouver scar scale，VSS）评分和疗效。结果：观察组创面完全愈合时间明显低于对照组，差异有统计学意义（P<0.05）。治疗6个月后，观察组瘢痕色泽、厚度、柔软度和血管分布评分及总分均低于对照组，差异有统计学意义（P<0.05）。观察组疗效为96.00%明显高于对照组的72.00%，差异有统计学意义（χ2=10.714，P=0.001）。结论：采用人工合成细胞活性因子rhEGF治疗面部深Ⅱ度烧伤的疗效确切，其可以促进创面愈合，抑制瘢痕生成。

[关键词]重组人表皮生长因子;面部;深Ⅱ度烧伤;创面修复;瘢痕;疗效

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2019）02-0036-03

Abstract： Objective  To observe the application of recombinant human epidermal growth factor （rhEGF） in the process of facial deep second degree burn wound repair. Methods  From June 2016 to January 2018， 100 patients with deep second degree burn of facial skin were treated in our hospital. The patients were divided into the observation group and the control group by random number table method. The control group received routine treatment， while the observation group was treated with rhEGF on the basis of the control group. The wound healing time， the vancouver scar scale （VSS） score after 6 months and the curative effect were compared between the two groups. Results  The healing time of wounds in the observation group was significantly lower than that in the control group， the difference was statistically significant（P<0.05）. After 6 months of treatment， the scar color， thickness， softness and vascular distribution score and total score of the observation group were lower than those of the control group（P<0.05）. The curative effect of the observation group was 96.00%， which was significantly higher than that of the control group （72.00%， χ2=10.714， P=0.001）. Conclusion  Synthetic cytokine rhEGF is effective in the treatment of facial deep second degree burn， which can promote wound healing and inhibit scar formation.

Key words： recombinant human epidermal growth factor（rhEGF）; face; deep second degree burn; wound repair; scar; curative effect

面部皮膚Ⅱ度烧伤在临床上较为常见，多采用预防感染、清创包扎和半暴露疗法进行治疗[1]。但是表皮组织的坏死使其失去了保护能力，伤后新形成的表皮薄且缺少弹性，易撕裂或脱落，导致患者治疗时间延长、病情反复，易发生感染。因此，如果治疗方法不当会导致瘢痕增生严重，影响皮肤外观和功能。如何促进创面愈合和改善患者预后？是治疗皮肤烧伤的重点内容[2]。创面的修复过程较为复杂，包括成纤维细胞的增殖分化、新生血管的形成和表皮细胞的增生等，在这一过程中表皮生长因子（epidermal growth factor， EGF）发挥关键作用，其可调控和促进与创面修复有关的细胞的增殖分化[3-4]。重组人表皮生长因子（recombinant human epidermal growth factor， rhEGF）是通过人工合成的EGF基因片段在大肠杆菌表达系统进行有效表达而获得的多肽物质，其活性及结构与天然产物高度一致[5]。笔者医院采用人工合成细胞活性因子rhEGF对面部皮肤深Ⅱ度烧伤患者进行治疗，取得较好疗效，现报道如下。……