湿润烧伤膏治疗糖尿病合并足部Ⅱ度烫伤疗效观察
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摘要
目的探讨湿润烧伤膏(moist exposed burn ointment, MEBO)治疗糖尿病合并足部Ⅱ度烫伤的临床疗效。方法回顾性分析南方医科大学附属南海医院烧伤整形外科2011年至2017年收治的符合纳入标准的69例糖尿病合并足部Ⅱ度烫伤患者的病历资料,根据治疗方法的不同将2015年至2017年收治并采用MEBO治疗局部创面的34例患者设为治疗组, 2011年至2014年收治并采用重组牛碱性成纤维细胞生长因子(recombinant bovine basic fibroblast growth factor, rb-bFGF)凝胶治疗局部创面的35例患者设为对照组,对比分析两组患者的创面愈合效果及愈合时间。结果治疗21 d后,治疗组患者的显效率为76.47%、总有效率为94.12%,明显优于对照组患者的显效率28.57%、总有效率68.57%,两组对比,P<0.01,差异具有统计学意义;最终两组患者创面均完全愈合,其中治疗组患者的创面愈合时间为(25.35±7.41) d,对照组患者的创面愈合时间(39.29±10.78) d,两组对比,P<0.01,差异具有统计学意义。结论 MEBO可有效促进糖尿病合并足部Ⅱ度烫伤患者的创面愈合,提高创面愈合效果,缩短创面愈合时间,且操作简便,值得临床推广应用。
Objective To observe the clinical effect of Moist Exposed Burn Ointment(MEBO) in the treatment of diabetes complicated with Ⅱ degree scald on foot.Methods Retrospective analysis was made on the medical records of 69 patients with diabetes complicated with Ⅱ degree scald on foot, admitted to the Department of Burn and Plastic Surgery of Nanhai Hospital Affiliated to Southern Medical University from 2011 to 2017. The 69 patients were divided, based on different treatment methods, into a treatment group-34 patients who were admitted to the hospital from 2015 to 2017 and treated with MEBO, and a control group-35 patients who were admitted to the hospital from 2011 to 2014 and treated with recombinant bovine basic fibroblast growth factor(rb-bFGF) gel. The wound healing effect and healing time were compared between the two groups.Results After 21 days of treatment, the effective rate and total effective rate in the treatment group were respectively 76. 47% and 94. 12%, significantly higher than that of the control group-respectively 28. 57% and 68. 57%,P<0. 01. The wounds in both groups were all healed completely at the end of treatment course. The wound healing time in the treatment group was(25. 35 ± 7. 41) d and(39. 29 ± 10. 78) d in the control groups, which showed statistically significant difference,P<0. 01.Conclusion MEBO, apart from its easy operation, can promote the wound healing of patients with diabetescomplicated withⅡdegree scald on foot and shorten the wound healing time, deserving to be promoted in clinical practice.
Objective To observe the clinical effect of Moist Exposed Burn Ointment(MEBO) in the treatment of diabetes complicated with Ⅱ degree scald on foot.Methods Retrospective analysis was made on the medical records of 69 patients with diabetes complicated with Ⅱ degree scald on foot, admitted to the Department of Burn and Plastic Surgery of Nanhai Hospital Affiliated to Southern Medical University from 2011 to 2017. The 69 patients were divided, based on different treatment methods, into a treatment group-34 patients who were admitted to the hospital from 2015 to 2017 and treated with MEBO, and a control group-35 patients who were admitted to the hospital from 2011 to 2014 and treated with recombinant bovine basic fibroblast growth factor(rb-bFGF) gel. The wound healing effect and healing time were compared between the two groups.Results After 21 days of treatment, the effective rate and total effective rate in the treatment group were respectively 76. 47% and 94. 12%, significantly higher than that of the control group-respectively 28. 57% and 68. 57%,P<0. 01. The wounds in both groups were all healed completely at the end of treatment course. The wound healing time in the treatment group was(25. 35 ± 7. 41) d and(39. 29 ± 10. 78) d in the control groups, which showed statistically significant difference,P<0. 01.Conclusion MEBO, apart from its easy operation, can promote the wound healing of patients with diabetescomplicated withⅡdegree scald on foot and shorten the wound healing time, deserving to be promoted in clinical practice.
引文
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[9]徐荣祥.烧伤治疗大全[M].北京:中国科学技术出版社,2008:554-556.
[10]唐乾利,韩珊珊,付军,等. MEBT/MEBO对皮肤创面愈合过程中VEGF、 bFGF、 EGF mRNA表达影响的研究[J].右江民族医学院学报, 2012, 34(5):597-601.
[11]唐乾利,李辉,李杰辉,等. MEBT/MEBO对糖尿病足溃疡创面超微病理及TGF?β1、 Smad3蛋白表达的影响[J].中国烧伤创疡杂志, 2015, 27(6):392-405.
[12]李杰辉,王丽,张春霞,等.湿润烧伤膏对糖尿病性溃疡大鼠创面组织晚期糖基化终末产物及其受体表达的影响研究[J].中国全科医学, 2016, 19(26):3153-3159.
[13]王权胜,唐乾利,伍松合,等. MEBT/MEBO阻止深Ⅱ度烧伤创面进行性加深机制的实验研究[J].中国烧伤创疡杂志, 2006, 18(4):256-259.
[14]陈永翀,李青,张泰安.烧伤再生医学与疗法创面治疗原则及机理阐述[J].中国烧伤创疡杂志, 2014, 26(1):1-14.
[2]陆树良,乔亮,谢挺,等.血糖及皮肤组织糖含量对大鼠浅二度烫伤创面愈合影响的实验研究[J].中华医学杂志, 2005,85(27):1899-1902.
[3]徐杰男,阙华发,唐汉钧,等.益气化瘀方促进糖尿病难愈创面血管新生的AGEs/RAGE/NF?κB信号通路研究[J].辽宁中医杂志, 2016, 43(1):154-158.
[4]陆树良.对创面修复关键问题的思考[J].中华烧伤杂志,2014, 30(2):95-99.
[5] Qi W, Yang C, Dai Z, et al. High levels of pigment epithelium?derived factor in diabetes impair wound healing through suppression of Wnt signaling[J]. Diabetes, 2015, 64(4):1407-1419.
[6]傅小兵,郭振荣,盛志勇.碱性成纤维细胞生长因子加速慢性难愈合创面愈合[J].中国修复重建外科杂志, 1999, 13(5):270-272.
[7]邢帮荣,利天增,卞徽宁,等.表皮生长因子与碱性成纤维细胞生长因子促进创面修复的比较研究[J].中华烧伤杂志,2003, 19(6):340-343.
[8]潘良利,程飚.糖尿病微血管形成障碍所涉及的重要组织结构与晚期糖基化终末产物的关系[J].感染、炎症、修复,2015, 16(3):189-192.
[9]徐荣祥.烧伤治疗大全[M].北京:中国科学技术出版社,2008:554-556.
[10]唐乾利,韩珊珊,付军,等. MEBT/MEBO对皮肤创面愈合过程中VEGF、 bFGF、 EGF mRNA表达影响的研究[J].右江民族医学院学报, 2012, 34(5):597-601.
[11]唐乾利,李辉,李杰辉,等. MEBT/MEBO对糖尿病足溃疡创面超微病理及TGF?β1、 Smad3蛋白表达的影响[J].中国烧伤创疡杂志, 2015, 27(6):392-405.
[12]李杰辉,王丽,张春霞,等.湿润烧伤膏对糖尿病性溃疡大鼠创面组织晚期糖基化终末产物及其受体表达的影响研究[J].中国全科医学, 2016, 19(26):3153-3159.
[13]王权胜,唐乾利,伍松合,等. MEBT/MEBO阻止深Ⅱ度烧伤创面进行性加深机制的实验研究[J].中国烧伤创疡杂志, 2006, 18(4):256-259.
[14]陈永翀,李青,张泰安.烧伤再生医学与疗法创面治疗原则及机理阐述[J].中国烧伤创疡杂志, 2014, 26(1):1-14.