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[摘要]目的：探究应用重组人表皮生长因子凝胶联合银离子敷料治疗压力性溃疡的临床效果。方法：选择2013年6月-2016年6月于笔者科室治疗的103例Ⅲ、Ⅳ期压疮患者为研究对象，常规清创消毒处理，对创面进行药物覆盖，随时清创，更换敷料。按外用药物的不同分为敷料组（n=35）、凝胶组（n=30）和联合组（n=38），定期观察各组各时间点创面愈合情况，分析比较各组患者创面面积缩小率及深度缩小率。结果：三组患者治疗后1周、2周创面面积缩小率及深度缩小率差异无统计学意义（P>0.05）；4周、8周时联合组明显优于敷料组及凝胶组，差异有统计学意义（P<0.05），敷料组与凝胶组相比，差异无统计学意义（P>0.05）。结论：重组人表皮生长因子凝胶联合银离子敷料治疗压力性溃疡，可促进创面愈合，降低炎症反应，安全有效，值得临床推广。
[关键词]压力性溃疡；表皮生长因子凝胶；银离子敷料；伤口愈合
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2017）09-0034-03
Treatment of Pressure Ulcer with Epidermal Growth Factor and Silver Ions Dressing
WANG Qiang，XIANG An-hua，PENG You-lin
（Department of Plastic Surgery，Xiaogan Hospital，Wuhan University of Science and Technology，Xiaogan 432000，Hubei，China）
Abstract： Objective To explore the clinical efficacy of recombinant human epidermal growth factor gel combined with silver ions dressing in the treatment of pressure ulcer. Methods A Total of 103 patients with stage Ⅲ and Ⅳpressure ulcer from June 2013 to June 2016 were selected as the subjects. Then the conventional debridement disinfection was carried out， and the wound was covered. Always clean up and change dressings. They were divided into dressing group（n=35）， gel group（n=30） and combined group （n=38） according to the difference of topical drugs. The wound healing at each time point of each group was observed regularly， and the wound area reduction rate and depth reduction rate were analyzed and compared. Results There was no significant difference between the three groups in the area reduction rate and the depth reduction rate after 1 and 2 weeks（P>0.05）. At 4 and 8 weeks， the combined group was significantly better than the dressing group and gel group， the difference was statistically significant（P<0.05）. There was no significant difference between the dressing group and the gel group at 4 and 8 weeks（P>0.05）. Conclusion Recombinant human epidermal growth factor gel combined with silver ion dressing for the treatment of pressure ulcer can accelerate the healing of pressure ulcer wounds and reduce inflammation reaction， which is safe and effective. It is worthy of clinical application.
Key words： pressure ulcer；epidermal growth factor gel；silver ions dressing；wound healing
壓疮，又称压力性溃疡、褥疮，是由于身体局部组织长期受压，发生持续性缺血、缺氧而导致的皮肤和/或皮下组织的局部损伤[1-2]，是对患者造成严重伤害的五大常见疾病之一[3]，特别是Ⅲ、Ⅳ期压疮可对患者的身心健康造成严重威胁[4]。2013年6月至2016年6月笔者科室对Ⅲ、Ⅳ期压疮患者使用重组人表皮生长因子凝胶联合银离子敷料治疗，加速了压力性溃疡创面的愈合，安全有效。
1 资料和方法
1.1 临床资料：本组病例103例，男性49例，女性54例；其中60～70岁33例，71～80岁61例，81岁以上9例，平均年龄78.5岁；压疮部位：骶尾部52例，足跟部34例，大转子处17例；创面大小约2cm×3cm～10cm×12cm。按区组随机化原则分为三组，分别为敷料组（银离子敷料治疗）35例、凝胶组（重组人表皮生长因子凝胶治疗）30例、联合组（重组人表皮生长因子凝胶联合银离子敷料治疗）38例。三组患者的性别、平均年龄、基础疾病和文化程度等基础资料无统计学差异（P>0.05），具有可比性。
[关键词]压力性溃疡；表皮生长因子凝胶；银离子敷料；伤口愈合
[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2017）09-0034-03
Treatment of Pressure Ulcer with Epidermal Growth Factor and Silver Ions Dressing
WANG Qiang，XIANG An-hua，PENG You-lin
（Department of Plastic Surgery，Xiaogan Hospital，Wuhan University of Science and Technology，Xiaogan 432000，Hubei，China）
Abstract： Objective To explore the clinical efficacy of recombinant human epidermal growth factor gel combined with silver ions dressing in the treatment of pressure ulcer. Methods A Total of 103 patients with stage Ⅲ and Ⅳpressure ulcer from June 2013 to June 2016 were selected as the subjects. Then the conventional debridement disinfection was carried out， and the wound was covered. Always clean up and change dressings. They were divided into dressing group（n=35）， gel group（n=30） and combined group （n=38） according to the difference of topical drugs. The wound healing at each time point of each group was observed regularly， and the wound area reduction rate and depth reduction rate were analyzed and compared. Results There was no significant difference between the three groups in the area reduction rate and the depth reduction rate after 1 and 2 weeks（P>0.05）. At 4 and 8 weeks， the combined group was significantly better than the dressing group and gel group， the difference was statistically significant（P<0.05）. There was no significant difference between the dressing group and the gel group at 4 and 8 weeks（P>0.05）. Conclusion Recombinant human epidermal growth factor gel combined with silver ion dressing for the treatment of pressure ulcer can accelerate the healing of pressure ulcer wounds and reduce inflammation reaction， which is safe and effective. It is worthy of clinical application.
Key words： pressure ulcer；epidermal growth factor gel；silver ions dressing；wound healing
壓疮，又称压力性溃疡、褥疮，是由于身体局部组织长期受压，发生持续性缺血、缺氧而导致的皮肤和/或皮下组织的局部损伤[1-2]，是对患者造成严重伤害的五大常见疾病之一[3]，特别是Ⅲ、Ⅳ期压疮可对患者的身心健康造成严重威胁[4]。2013年6月至2016年6月笔者科室对Ⅲ、Ⅳ期压疮患者使用重组人表皮生长因子凝胶联合银离子敷料治疗，加速了压力性溃疡创面的愈合，安全有效。
1 资料和方法
1.1 临床资料：本组病例103例，男性49例，女性54例；其中60～70岁33例，71～80岁61例，81岁以上9例，平均年龄78.5岁；压疮部位：骶尾部52例，足跟部34例，大转子处17例；创面大小约2cm×3cm～10cm×12cm。按区组随机化原则分为三组，分别为敷料组（银离子敷料治疗）35例、凝胶组（重组人表皮生长因子凝胶治疗）30例、联合组（重组人表皮生长因子凝胶联合银离子敷料治疗）38例。三组患者的性别、平均年龄、基础疾病和文化程度等基础资料无统计学差异（P>0.05），具有可比性。