重组人粒细胞巨噬细胞集落刺激因子对深Ⅱ度烧伤创面清创及愈合的影响

[Effect of recombinant human granulocyte-macrophage colony-stimulating factor on wound debridement and healing of deep II thickness burn].

作者信息

Liu Lisong, Fang Yong, Yao Min, Yu Weirong, Li Xiaoguang

机构信息

Department of Burn and Plastic Surgery, Third People's Hospital, Institute of Trauma, Shanghai Jiaotong University School of Medicine, Shanghai 201900, PR China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Sep;25(9):1059-62.

PMID:21991809

Abstract

OBJECTIVE

To investigate the effectiveness and mechanism of recombinant human granulocyte-macrophage colony-stimulating factor (rhGMCSF) gel on wound debridement and healing of deep II thickness burn.

METHODS

Between December 2008 and December 2010, 58 patients with deep II thickness burn, accorded with the inclusive criteria, were collected. There were 36 males and 22 females with an average age of 32.4 years (range, 12-67 years). The causes were hot liquid in 38 cases and fire in 20 cases. The time from injury to treatment was 1-3 days (mean, 2.1 days). In this randomized, double-blind, and self-control study, all patients were randomly divided into 2 groups, wounds were treated with rhGMCSF gel (test group) or gel matrix (control group). There was no significant difference in wound area between 2 groups (P > 0.05). The time of completed removal eschar and the percentage of removal-area of eschar were recorded at 2, 6, 10, 14, and 18 days during healing process. The time of wound healing was also recorded.

RESULTS

Compared with control group, the necrotic tissues on the burn wound got soft in test group at 4 days after treatment. At 6 days, they loosened and eventually sloughed off. The wound bed presented in red and white, followed by rapidly growing granulation tissues. Except 18 days after treatment, there were significant differences in the percentage of removal-area of eschar between 2 groups (P < 0.05). The time of completed removal eschar in test group [(7.71 +/- 2.76) days] was significantly shorter than that in control group [(14.71 +/- 3.63) days] (t = 13.726, P = 0.000). The time of wound healing in test group was (18.41 +/- 2.47) days, which was significantly shorter than that in control group [(23.58 +/- 3.35) days] (t = 15.763, P = 0.000).

CONCLUSION

Compared with the gel matrix, the rhGMCSF gel may promote wound debridement and healing in deep II thickness burn.

摘要

目的

探讨重组人粒细胞巨噬细胞集落刺激因子（rhGMCSF）凝胶对深Ⅱ度烧伤创面清创及愈合的效果和机制。

方法

收集2008年12月至2010年12月符合纳入标准的58例深Ⅱ度烧伤患者。其中男性36例，女性22例，平均年龄32.4岁（范围12 - 67岁）。致伤原因：热液烫伤38例，火焰烧伤20例。伤后至治疗时间为1 - 3天（平均2.1天）。在这项随机、双盲、自身对照研究中，所有患者随机分为2组，创面分别用rhGMCSF凝胶（试验组）或凝胶基质（对照组）治疗。两组创面面积差异无统计学意义（P > 0.05）。记录愈合过程中第2、6、10、14和18天痂皮完全脱落时间及痂皮脱落面积百分比。同时记录创面愈合时间。

结果

与对照组相比，试验组治疗4天后烧伤创面坏死组织变软，6天时松动并最终脱落，创面床呈红白相间，随后肉芽组织迅速生长。除治疗18天后外，两组痂皮脱落面积百分比差异有统计学意义（P < 0.05）。试验组痂皮完全脱落时间为（7.71 ± 2.76）天，明显短于对照组的（14.71 ± 3.63）天（t = 13.726，P = 0.000）。试验组创面愈合时间为（18.41 ± 2.47）天，明显短于对照组的（23.58 ± 3.35）天（t = 15.763，P = 0.000）。