林颜 陈晓东 阮树斌 杨荣华 王婧薷

【摘要】 目的：分析并探討重组人碱性成纤维细胞生长因子对难愈性创面愈合相关指标表达的影响，为临床治疗提供参考依据。方法：选取2019年1月-2020年12月笔者所在医院收治的难愈性创面患者100例作为观察对象，按照随机数字表法将其分为研究组和对照组，每组50例。两组患者均进行常规治疗，在此基础上研究组患者给予重组人碱性成纤维细胞生长因子治疗。对比两组患者的治疗效果及治疗期间的不良事件发生情况，对比两组患者治疗7、14 d的创面愈合面积和后期换药次数、创面愈合时间、住院时间，对比两组患者治疗前后的疼痛情况及炎症因子水平。结果：经过治疗，研究组患者的治疗总有效率为92.00%，明显高于对照组的76.00%，差异有统计学意义（P<0.05）。研究组患者的不良事件发生率为10.00%，稍微低于对照组的18.00%，但两组对比差异无统计学意义（P>0.05）。与对照组患者对比，研究组患者治疗7、14 d的创面面积均缩小，后期换药次数更少，创面愈合时间及住院时间均更短，差异均有统计学意义（P<0.05）。两组患者治疗前的疼痛情况对比，差异无统计学意义（P>0.05），研究组患者治疗7、14 d的疼痛VAS评分均明显低于对照组（P<0.05）。两组患者治疗前及治疗7 d的炎症因子水平对比，差异均无统计学意义（P>0.05），且治疗7 d的炎症因子水平均较治疗前有升高的趋势（P<0.05），但两组治疗14 d的炎症因子水平均较治疗7 d明显下降（P<0.05），且研究组治疗14 d的IL-6、TNF-α、CRP均明显低于对照组（P<0.05）。结论：在难愈性创面患者的治疗中，重组人碱性成纤维细胞生长因子治疗的效果较好，可有效提高创面愈合率，缩短创面愈合时间及住院时间，缓解患者的疼痛情况，调节炎症因子水平，值得临床推广应用。

【关键词】 重组人碱性成纤维细胞生长因子 难愈性创面 炎症因子

Effect of Recombinant Human Basic Fibroblast Growth Factor on the Expression of Healing Related Indexes in Refractory Wounds/LIN Yan， CHEN Xiaodong， RUAN Shubin， YANG Ronghua， WANG Jingru. //Medical Innovation of China， 2021， 18（14）： 059-063

[Abstract] Objective： To analyze and explore the effect of Recombinant Human Basic Fibroblast Growth Factor on the expression of healing related indexes of refractory wounds， so as to provide reference for clinical treatment. Method： A total of 100 patients with refractory wounds in our hospital from January 2019 to December 2020 were selected as the observation objects， they were randomly divided into study group and control group， with 50 cases in each group. Two groups of patients were treated with conventional treatment， on this basis， the study group was treated with Recombinant Human Basic Fibroblast Growth Factor. The treatment effect and adverse events during the treatment were compared between the two groups. The wound healing area， dressing change times of later period， wound healing time and hospital stay were compared between the two groups 7 d and 14 d after operation. The pain and inflammatory factors were compared between the two groups before and after treatment. Result： After treatment， the total effective rate of the study group was 92.00%， which was significantly higher than 76.00% of the control group， the difference was statistically significant （P<0.05）. The incidence of adverse events in the study group was 10.00%， slightly lower than 18.00% in the control group， but there was no significant difference （P>0.05）. Compared with the control group， the wound area of the study group were reduced at 7 and 14 d after treatment， with fewer times of dressing change at later stage， shorter wound healing time and shorter hospital stay， the differences were statistically significant （P<0.05）. There was no significant difference in the pain before treatment between the two groups （P>0.05）; the VAS score of the study group was significantly lower than that of the control group at 7 and 14 d after treatment （P<0.05）. There were no significant differences in the levels of inflammatory factors between two groups before treatment and 7 d after treatment （P>0.05）， and the levels of inflammatory cytokines increased at 7 d after treatment （P<0.05）， but the levels of inflammatory cytokines in both groups were significantly lower after 14 d of treatment than after 7 d of treatment （P<0.05）， and the IL-6， TNF-α and CRP in the study group were significantly lower than those in the control group （P<0.05）. Conclusion： In the treatment of patients with refractory wounds， the effect of Recombinant Human Basic Fibroblast Growth Factor is better， which can effectively improve the wound healing rate， shorten the wound healing time and hospitalization time， relieve the pain of patients， and regulate the level of inflammatory factors， which is worthy of clinical application.

[Key words] Recombinant Human Basic Fibroblast Growth Factor Refractory wound Inflammatory factors

First-authors address： The First Peoples Hospital of Foshan City， Foshan 528000， China

doi：10.3969/j.issn.1674-4985.2021.14.015

难愈性创面是指经过常规治疗6周后，患者的创口仍然无法愈合或者未见愈合的趋势，此类患者的创面一般面积较大，可见于烧伤、烫伤、手术、糖尿病导致的溃疡、感染性溃疡等较多疾病，这对患者的身心健康及生活质量均造成严重的影响[1]。近些年来，临床多使用持续封闭负压引流技术（VSD）对难愈性创面进行治疗，其可有效减轻创面水肿及炎症因子水平，加速创面的愈合，但对于创面较大或者慢性溃疡的创面，其愈合速度仍然较慢，整体效果不是十分理想。……