El Saghir N S, Bizri A R, Shabb N S, Husami T W, Salem Z, Shamseddine A I
Department of Medicine, American University of Beirut Medical Center, Lebanon.
J Infect. 1997 Sep;35(2):179-82. doi: 10.1016/s0163-4453(97)91809-0.
This is the first report of granulocyte macrophage-colony stimulating factor (GM-CSF) inducing accelerated healing of a sacral pressure ulcer in a bedridden patient with bilateral hemiplegia. GM-CSF was diluted and injected locally around and into the ulcer bed every 2-3 days for 2 weeks, then weekly for 4 weeks until complete healing occurred. A new firm granulation tissue was noted within a few days. The ulcer showed 85% healing within 2 weeks and 100% by 2 months. Healing started from the periphery and from within the ulcer bed at sites of GM-CSF injections. It was slower at areas where there was complete necrosis and detachment of skin from underlying tissue. The ulcer remained closed until the patient's sudden death 9 months later. A biopsy of granulation tissue showed inflammatory cells and reactive fibroblasts. The potential role of GM-CSF and growth factors in pressure ulcer therapy and wound healing are discussed.
这是关于粒细胞巨噬细胞集落刺激因子（GM-CSF）促使一名双侧偏瘫卧床患者骶部压疮加速愈合的首份报告。GM-CSF经稀释后，每2 - 3天在溃疡床周围及床内局部注射，持续2周，之后每周注射1次，共4周，直至完全愈合。数天内可见新的坚实肉芽组织。溃疡在2周内愈合85%，2个月时100%愈合。愈合从溃疡周边及GM-CSF注射部位的溃疡床内部开始。在皮肤与深层组织完全坏死和分离的区域愈合较慢。溃疡一直保持愈合状态，直至9个月后患者突然死亡。肉芽组织活检显示有炎性细胞和反应性成纤维细胞。文中讨论了GM-CSF和生长因子在压疮治疗及伤口愈合中的潜在作用。
