唐强,韦万勉,黄志群,陆钢,吴寅,唐乾利.MEBT / MEBO 与重组牛碱性成纤维细胞生长因子 治疗糖尿病足的疗效对比分析[J].中国烧伤创疡杂志,2021,(3):168~172. |
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中文关键词: 皮肤再生医疗技术 重组牛碱性成纤维细胞生长因子 Wagner 分级 糖尿病足 创面 |
英文关键词:MEBT/MEBO Recombinant bovine basic fibroblast growth factor Wagner classification Diabetic foot Wound |
基金项目:国家自然科学基金面上项目(81774327); “广西特聘专家” 专项经费资助项目(桂人才通字[2019] 13 号); 广西 医学高层次领军人才培养 “139” 计划资助项目(桂卫科教发[2018] 22 号); 右江民族医学院附属医院高层次人才 科研项目(R202011706) |
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中文摘要: |
【摘要】目的 对比分析皮肤再生医疗技术(MEBT/ MEBO)与重组牛碱性成纤维细胞生长因子治疗糖尿病足的临床疗效? 方法 选取2018 年2月至2019 年12月右江民族医学院附属医院烧伤整形与创面修复外科收治的60 例Wagner 2 ~ 4级糖尿病足患者作为研究对象, 采用随机数表法将其随机分为MEBT/ MEBO组和贝复新组,每组30例, MEBT/ MEBO组患者创面采用 MEBT/ MEBO治疗, 贝复新组患者创面采用重组牛碱性成纤维细 胞生长因子凝胶(贝复新) 治疗, 对比两组患者治疗第 14? 21? 28 天时创面肉芽化率?上皮化率, 治疗期间感染情况, 创面愈合时间及瘢痕增生情况? 结果 治疗第 14? 21? 28 天, 两组患者创面肉芽化率?上皮化率均随 时间推移逐渐升高, 且各时间点两组间均无明显差异(创面肉芽化率: t = 0. 588? 1. 009? 0. 636, P = 0.559? 0.317? 0.527; 创面上皮化率: t = 0. 857? 1.581? 1?? 972, P = 0.395? 0. 120? 0.053); 治疗过程中, MEBT/ MEBO组患者创面感染率为 10. 0% , 明显低于贝复新组患者的创面感染率 36.7%( χ 2 = 5.963, P = 0.015); MEBT/ MEBO组患者创面愈合时间明显长于贝复新组( t = 2.484, P = 0.016); 创面愈合后 MEBT/ MEBO组患者 瘢痕增生率为 26.7% , 与贝复新组患者的瘢痕增生率33.3%相比无明显差异( t = 0.317, P = 0.573)? 结论 MEBT/ MEBO 与重组牛碱性成纤维细胞生长因子均能有效促进糖尿病足创面肉芽化?上皮化,并预防愈后皮肤瘢痕增生, 但与重组牛碱性成纤维细胞生长因子相比,MEBT/ MEBO能够更显著降低创面感染率, 但促进创面愈合的效果略差, 临床中应根据具体情况选择适宜方法治疗? |
英文摘要: |
【Abstract】Objective To compare the clinical efficacy of MEBT/MEBO and recombinant bovine basic fibroblast growth factor(rbFGF) in the treatment of diabetic foot. Methods Sixty patients with Wagner grade 2-4 diabetic foot, admitted to the Surgery Department of Burn Plastics and Wound Repair of the Affiliated Hospital of Youjiang Medical University for Nationalities from February 2018 to December 2019, were selected as the research subjects and divided, according to the random number table, into MEBT/MEBO group and rbFGF group, with 30 cases in each group. Patients in MEBT/MEBO group were treated with MEBT/MEBO, whereas patients in the rbFGF group were treated with recombinant bovine basic fibroblast growth factor(rbFGF) gel. Comparison was performed between the two groups respectively on day 14, 21 and 28 of treatment in terms of wound granulation rate, epithelialization rate, infection condition during the treatment course, wound healing time, and scar hyperplasia. Results On the 14, 21, and 28 day of treatment, the wound granulation rate and epithelialization rate of patients in the two groups increased over time, and no significant difference was observed between the two groups at each time point(wound granulation rate: t=0.588, 1.009 and 0.636, P=0.559, 0.317 and 0.527; epithelialization rate: t=0.857, 1.581 and 1.972, P=0.395, 0.120 and 0.053). During the treatment course, the wound infection rate of patients in the MEBT/MEBO group was 10.0%, lower than 36.7% in the rbFGF group(χ2=5.963, P=0.015); the wound healing time in the MEBT/MEBO group was significantly longer than that in the rbFGF group(t=2.484, P=0.016); and the rate of scar hyperplasia was 26.7% in the MEBT/MEBO group, which presented no significant difference as compared with the corresponding 33.3% in the rbFGF group(t=0.317, P=0.573). Conclusion Both MEBT/MEBO and recombinant bovine basic fibroblast growth factor(rbFGF) can effectively promote the wound granulation and epithelialization of diabetic foot, and prevent the formation of scar hyperplasia after wound healing. However, compared with recombinant bovine basic fibroblast growth factor, MEBT/ MEBO is better in reducing the infection rate of wounds, though it needs more time to accomplish wound healing. In clinical practice, specific conditions should be considered when selecting the treatment method. |
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