重组人表皮生长因子凝胶对老年混合痔患者术后创面恢复的影响研究

摘要

Objective To study the effect of recombinant human epidermal growth factor (rh-EGF) gel on postoperative wound healing in older patients with mixed hemorrhoids.Methods 90 older patients with mixed hemorrhoids who were treated in our hospital from October 2013 to October 2016 were enrolled in this study.They were randomly assigned into three groups,with 30 cases in each group.The three groups were treated with mixed hemorrhoidectomy.Group A was treated with routine treatment,group B with rh-EGF gel,and group C with rh-EGF solvent.Wound healing rate,wound pain and bleeding,time to wound healing were compared among the three groups.Levels of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) and wound tissue proliferation index of DNA (PI) were also compared.Results There was no significant difference in wound healing rate among the three groups 3 d and 2 w after operation (P ＞ 0.05).There was a significant difference in wound healing rate among the three groups 1 w after operation (P ＜0.05).Before treatment,GH,IGF-1 and PI levels showed no significant among-group difference (P ＞ 0.05).At the end of treatment,the differences were statistically significant (P ＜ 0.05),with significantly higher levels in group B than in group A and C (P ＜ 0.05).After 3 d,wound pain and wound bleeding score differed significantly among groups (P ＜ 0.05),with wound pain and bleeding scores in group B significantly lower than in group A and C (P ＜ 0.05).Wound pain and wound bleeding scores on the day of surgery,and 1 w and 2 w after operation showed no significant differences among groups (P ＞ 0.05).Conclusion rh-EGF gel can promote wound healing and improve wound pain and wound bleeding in older patients with mixed hemorrhoids.%目的 研究重组人表皮生长因子(rhEGF)凝胶对老年混合痔患者术后创面愈合的影响.方法 纳入2013年10月至2016年10月本院收治的90例老年混合痔患者作为研究对象,随机分为三组,每组各30例.三组患者均接受混合痔切除术,术后A组常规治疗,B组给予rh-EGF凝胶,C组给予rh-EGF溶剂.比较三组不同时点创面愈合率、创面疼痛及出血情况,三组创面愈合中位时间,不同时点血清生长激素(GH)和胰岛素样生长因子-1(IGF-1)及创面组织DNA增殖指数(PI)水平.结果 三组术后3d和术后2w时创面愈合率差异均无统计学意义(均P＞0.05),术后1w时三组创面愈合率差异有统计学意义(P＜0.05).治疗前,三组间GH、IGF-1及PI水平差异均无统计学意义(均P＞0.05);治疗结束时,三组间GH、IGF-1及PI水平差异均有统计学意义(均P＜ 0.05),B组各指标均显著高于A、C两组,差异均有统计学意义(均P＜0.05).术后3d,三组间创口疼痛及创口出血评分差异均有统计学意义(均P＜ 0.05),B组创面疼痛和出血评分均显著低于A、C两组,差异均有统计学意义(均P＜0.05);手术当天、术后1 w及术后2w三组间创口疼痛及创口出血评分差异均无统计学意义(均P＞0.05).结论 rh-EGF凝胶可有助于促进老年混合痔患者术后创面愈合及改善创口疼痛、创口出血情况.