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目的探讨重组人EGF(recombinant human EGF,rhEGF)修复老年患者Ⅱ度烧伤创面的疗效。方法2003年2月-2008年10月,收治80例Ⅱ度烧伤老年患者,根据治疗方法不同,随机分为两组(n=40)。治疗组:男24例,女16例;年龄60～86岁,平均70岁。火焰烧伤23例,热液烫伤16例,电烧伤1例。浅Ⅱ度20例,深Ⅱ度20例。受伤至入院时间(2.87±2.57)h。创面使用磺胺嘧啶银联合rhEGF治疗。对照组:男18例,女22例;年龄61～83岁,平均69岁。火焰烧伤23例,热液烫伤14例,电烧伤2例,化学烧伤1例。浅Ⅱ度19例,深Ⅱ度21例。受伤至入院时间(3.39±3.33)h。创面外敷磺胺嘧啶银。两组均每日换药1次,至创面愈合。两组患者一般资料比较,差异无统计学意义(P>0.05),具有可比性。结果治疗组深Ⅱ度1例、对照组深Ⅱ度5例创面超过40d不愈合,改用游离植皮修复;对照组浅Ⅱ度1例中途放弃治疗;治疗组深Ⅱ度1例因肺部感染死亡;均排除研究。共72例纳入分析,其中治疗组38例,对照组34例。治疗组rhEGF喷洒时4例出现一过性刺痛,2例出现瘙痒,其余患者治疗期间未发现全身不适及中毒症状。对照组和治疗组分别有5例和3例发生创面感染,经对症处理后愈合。治疗组创面愈合时间浅Ⅱ度(14.30±1.26)d、深Ⅱ度(26.11±2.97)d,对照组分别为(16.22±1.40)d及(29.13±4.99)d,差异有统计学意义(P<0.05)。结论在综合治疗的同时创面局部使用rhEGF能有效促进老年患者Ⅱ度烧伤创面的愈合和修复。
Objective To investigate the effect of recombinant human EGF (rhEGF) in the treatment of second degree burn wounds in elderly patients. Methods From February 2003 to October 2008, 80 elderly patients with grade Ⅱ burn were randomly divided into two groups according to the different treatment methods (n = 40). Treatment group: 24 males and 16 females; aged 60 to 86 years, mean 70 years. 23 cases of flame burns, 16 cases of hydrothermal burns and 1 case of electric burn. 20 cases of superficial second degree, 20 cases of deep second degree. Injured to admission time (2.87 ± 2.57) h. The wounds were treated with silver sulfadiazine and rhEGF. Control group: 18 males and 22 females; aged 61 to 83 years, mean 69 years. 23 cases of flame burns, 14 cases of hydrothermal burns, 2 cases of electric burns and 1 case of chemical burns. Shallow Ⅱ degree in 19 cases, deep Ⅱ degree in 21 cases. Injured to admission time (3.39 ± 3.33) h. Wound topical sulfadiazine silver. Two groups were daily dressing 1, to the wound healing. The two groups of patients with general information, the difference was not statistically significant (P> 0.05), comparable. Results In the treatment group, the deep Ⅱ degree was found in 1 case. In the control group, 5 cases of deep Ⅱ degree wound did not heal more than 40 days, and then replaced by free skin graft. In the control group, Death; all exclude research. A total of 72 cases were included in the analysis, including 38 cases in the treatment group and 34 cases in the control group. In the treatment group, transient tingling occurred in 4 cases when rhEGF was sprayed and pruritus occurred in 2 cases. No symptoms of generalized malaise and poisoning were observed in the rest of the patients during the treatment. The control group and treatment group were 5 and 3 cases of wound infection, after symptomatic healing. The wound healing time of the treatment group was (Ⅱ) (14.30 ± 1.26) d and deep Ⅱ degree (26.11 ± 2.97) days respectively, while the control group was (16.22 ± 1.40) d and (29.13 ± 4.99) d respectively, with significant difference <0.05). CONCLUSION: RhEGF can effectively promote the healing and repair of second-degree burn wounds in elderly patients.