超声清创联合重组人表皮生长因子治疗肛周脓肿感染的疗效观察

徐朝晖; 周乐; 蒋胜华; 许宝才; 沈忠

doi:10.16766/j.cnki.issn.1674-4152.002408

超声清创联合重组人表皮生长因子治疗肛周脓肿感染的疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002408

1.
衢州市中医医院肛肠科，浙江衢州 324002
2.
衢州市中医医院脾胃病科，浙江衢州 324002
3.
杭州市第三人民医院肛肠科，浙江杭州 310000

基金项目:

浙江省基础公益研究计划项目 LGF20H030002

详细信息

通讯作者:
徐朝晖，E-mail：xxuchaohui@163.com

中图分类号: R657.15
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-15
- 网络出版日期: 2022-08-20

Efficacy of the treatment with ultrasonic debridement combined with RhEGF in patients with perianal abscess infection

1.
Department of Anorectal Medicine, Quzhou Hospital of Traditional Chinese Medicine, Quzhou, Zhejiang 324002, China

摘要

摘要: 目的探讨超声清创联合重组人表皮生长因子(RhEGF)治疗肛周脓肿感染的疗效。方法选取2019年2月—2021年2月衢州市中医医院收治的112例肛周脓肿感染患者，按照治疗方法的不同将其分为超声组(37例)、RhEGF组(37例)、观察组(38例)。3组患者均常规给予抗菌药物，超声组给予超声清创治疗，RhEGF组给予RhEGF治疗，观察组给予超声清创联合RhEGF治疗。比较3组患者临床指标水平、疼痛程度、创面细菌清除率、微循环指标水平。结果观察组创面愈合时间[(15.49±2.18)d]、住院时间[(15.53±2.06)d]短于超声组[(18.06±2.01)、(18.52±1.73)d]、RhEGF组[(17.84±1.93)、(17.98±1.85)d, F=18.291、26.852，均P < 0.001]；3组患者治疗后1 d视觉模拟量表评分低于治疗前(均P < 0.05)，且观察组低于超声组、RhEGF组(F=30.093，P < 0.001)；3组患者治疗后3 d创面细菌清除率高于治疗后1 d(均P < 0.05)，且观察组治疗后1、3 d创面细菌清除率高于超声组、RhEGF组(F=22.183、31.650，均P < 0.001)；3组患者治疗后1 d创面血流量、经皮氧分压及血清表皮生长因子水平高于治疗前(均P < 0.05)，且观察组高于超声组、RhEGF组(F=4.406、20.210、51.552，P值为0.015、 < 0.001、 < 0.001)。结论超声清创联合RhEGF治疗肛周脓肿感染疗效显著，有助于患者早日康复。
- 超声清创 /
- 重组人表皮生长因子 /
- 肛周脓肿感染 /
- 创面愈合 /
- 微循环
Abstract: Objective To explore the efficacy of the treatment with ultrasonic debridement combined with recombinant human epidermal growth factor (RhEGF) in perianal abscess infection. Methods A total of 112 patients with perianal abscess infection admitted to Quzhou Hospital of Traditional Chinese Medicine, Zhejiang Province from Feb. 2019 to Feb. 2021 were selected and divided into ultrasound group (n=37), RhEGF group (n=37) and observation group (n=38) according to different treatment methods. Three group were given conventional antibiotics, the ultrasound group was treated with ultrasonic debridement, the RhEGF group was treated with RhEGF, and the observation group was treated with ultrasonic debridement combined with RhEGF. The clinical index level, pain degree, wound bacterial clearance rate and microcirculation index level were compared of three groups. Results The wound healing time and hospital stay in the observation group [(15.49±2.18) d, (15.53±2.06) d] were lower than those in the ultrasound group [(18.06±2.01) d, (18.52±1.73) d] and RhEGF group [(17.84±1.93) d, (17.98±1.85) d, F=18.291, 26.852, all P < 0.001]. The visual analogue scale score of 3 groups after treatment 1 d was lower than that before treatment (all P < 0.05), and the observation group was lower than that in the ultrasound group and RhEGF group (F=30.093, P < 0.001). The wound bacterial clearance rate of 3 groups after treatment 3 d was higher than that in after treatment 1 d (all P < 0.05), and the wound bacterial clearance rate after treatment 1 d and 3 d in the observation group were higher than those in the ultrasound group and RhEGF group (F=22.183, 31.650, all P < 0.001). The wound blood flow, percutaneous partial oxygen pressure and the level of serum epidermal growth factor of 3 groups after treatment 1 d were higher than those before treatment (all P < 0.05), and the observation group were higher than those in the ultrasound group and RhEGF group (F=4.406, 20.210, 51.552, the P value were 0.015, < 0.001, < 0.001, respectively). Conclusion Ultrasonic debridement combined with RhEGF is effective in the treatment of perianal abscess infection, which is helpful to the early recovery of patients.
- Ultrasonic debridement /
- Recombinant human epidermal growth factor /
- Perianal abscess infection /
- Wound healing /
- Microcirculation

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表 1 3组肛周脓肿感染患者一般资料比较

Table 1. Comparison of general data of three groups of patients with perianal abscess infection

组别	例数	性别(例)		年龄(x±s, 岁)	病程(x±s, d)	脓肿面积(x±s, cm²)	脓肿部位(例)
组别	例数	男性	女性	年龄(x±s, 岁)	病程(x±s, d)	脓肿面积(x±s, cm²)	高位肌间	直肠后间隙	骨盆直肠间隙
超声组	37	21	16	44.72±9.16	8.01±1.37	10.19±1.75	8	20	9
RhEGF组	37	23	14	43.15±8.57	8.22±1.66	10.53±1.84	10	19	8
观察组	38	25	13	46.93±7.22	7.85±1.14	10.41±1.62	9	22	7
统计量		0.654^a		1.944^b	0.654^b	0.364^b	0.683^a
P值		0.721		0.148	0.529	0.696	0.953
注：^a为χ²值，^b为F值。

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表 2 3组肛周脓肿感染患者临床指标比较(x±s, d)

Table 2. Comparison of clinical indicators in three groups of patients with perianal abscess infection (x±s, d)

组别	例数	创面愈合时间	住院时间
超声组	37	18.06±2.01^a	18.52±1.73^a
RhEGF组	37	17.84±1.93^a	17.98±1.85^a
观察组	38	15.49±2.18	15.53±2.06
F值		18.291	26.852
P值		< 0.001	< 0.001
注：与观察组比较，^aP < 0.05。

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表 3 3组肛周脓肿感染患者VAS评分比较(x±s, 分)

Table 3. Comparison of VAS scores in three groups of patients with perianal abscess infection (x±s, d)

组别	例数	治疗前	治疗后1 d
超声组	37	6.34±1.72	4.05±0.77^ab
RhEGF组	37	6.19±1.36	3.86±0.69^ab
观察组	38	6.47±1.08	2.97±0.43^b
F值		0.371	30.093
P值		0.691	< 0.001
注：与观察组比较，^aP < 0.05；与同组治疗前比较，^bP < 0.05。

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表 4 3组肛周脓肿感染患者创面细菌清除率比较(x±s, %)

Table 4. Comparison of bacterial clearance rate of wounds in three groups of patients with perianal abscess infection (x±s, %)

组别	例数	治疗后1 d	治疗后3 d
超声组	37	53.72±6.26^a	65.32±7.47^ab
RhEGF组	37	54.37±6.63^a	67.15±8.39^ab
观察组	38	62.84±6.97	78.43±7.34^b
F值		22.183	31.650
P值		< 0.001	< 0.001
注：与观察组比较，^aP < 0.05；与同组治疗后1 d比较，^bP < 0.05。

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表 5 3组肛周脓肿感染患者微循环指标比较(x±s)

Table 5. Comparison of microcirculation indexes in three groups of patients with perianal abscess infection (x±s)

组别	例数	创面血流量(PU)		经皮氧分压(mm Hg)		血清EGF(μg/L)
组别	例数	治疗前	治疗后1 d	治疗前	治疗后1 d	治疗前	治疗后1 d
超声组	37	0.69±0.22	0.76±0.21^ab	27.84±3.20	31.29±3.47^ab	0.19±0.04	0.49±0.05^ab
RhEGF组	37	0.72±0.27	0.82±0.28^ab	28.16±3.88	32.16±3.35^ab	0.21±0.06	0.51±0.06^ab
观察组	38	0.74±0.23	0.93±0.26^b	28.23±3.16	36.23±3.94^b	0.20±0.05	0.63±0.08^b
F值		0.409	4.406	0.137	20.210	1.442	51.552
P值		0.888	0.015	0.872	< 0.001	0.241	< 0.001
注：与观察组比较，^aP < 0.05；与同组治疗前比较，^bP < 0.05。1 mm Hg=0.133 kPa。

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