摘要
目的:探讨伤后24h 内削痂手术对深Ⅱ度烧伤创面局部释放表皮生长因子(EGF)、碱性成纤维细胞生长因子(FGF-2)、血小板衍生生长因子(PDGF-AB)及其对组织修复的影响。方法:选12例以深Ⅱ度烧伤为主的患者,每例患者均选择相对均匀的深Ⅱ度创面作为实验创面并分为3个研究区域,即手术前、手术后和未手术实验区。伤后24h 内行削痂术。术前在实验创面切取创面组织,作为手术前实验区标本,行削痂后创面均以辐照猪皮覆盖。术中部分创面保留不予手术,该保留创面作为未手术实验区。于伤后5～7d 行第2次手术,分别切取经削痂处理和未手术区的创面组织,作为手术后和未手术实验区标本。采用组织培养和 ELISA 技术测定创面组织释放 EGF、FGF-2和 PDGF-AB 的水平,并对创面组织中新生肉芽形成进行形态学观察和半定量分析。结果:伤后24h 内削痂手术后,创面组织局部释放 EGF、FGF-2和 PDGF-AB 的水平较手术前和未手术创面有显著升高(P<0.05);创面局部组织形态学观察显示,手术后创面新鲜肉芽组织形成较手术前和未手术创面显著(P<0.05)。结论:伤后24h 内削痂手术可以促进局部组织释放 EGF、FGF-2和 PDGF-AB,促进新生肉芽形成,有利于深Ⅱ度烧伤创面愈合,从而提示了伤后24h 内削痂优于常规手术。
Objective:To evaluate the local EGF,FGF-2 and PDGF-AB release and wound healing of deep partial thickness burn wounds after tangential excision within 24 hours postburn.Methods:Twelve patients with deep partial thickness burns were enrolled in our study.Tangential excision was performed within 24 hours postburn. The wound was divided into three areas:the pre-operation area,post-operation area and non-operation area.For each patient,the sample from the pre-operation area was collected before the tangential excision and those from post-operation and non-operation area were gained on days 5-7 postburn.The samples were cultured and his- topathologically examined,as well as the levels of EGF,FGF-2 and PDGF-AB release were determined.Results: The results showed that compared with non-operation area the level of EGF,FGF-2 and PDGF-AB released by lo- cal wound tissue was significantly increased in post- operation area,while the fresh granulation tissue formation was more exuberant as shown in histopathological examination.Conclusion:The study suggested that the release of EGF,FGF-2 and PDGF-AB from wound tissue could be enhanced by tangential excision within 24 hours after burn injury,thus promoting the healing process in deep partial thickness burns.
出处
《感染．炎症．修复》
2002年第3期153-155,共3页
Infection Inflammation Repair
基金
国家重点基础研究发展规划项目资助(1999054205)
关键词
烧伤
削痂
生长因子
创面愈合
Burn
Tangential excision
Growth factor
Wound healing
