2019 年第 9 期 第 14 卷

重症烧伤患者应用重组人生长激素治疗对相关指标及治疗效果的影响

Therapeutic effect of recombinant human growth hormone on severe burn patients

作者：梁敏计鹏

英文作者：

单位：710032西安，空军军医大学第一附属医院烧伤与皮肤外科全军烧伤中心

英文单位：

关键词：重症烧伤；重组人生长激素；糖代谢；蛋白合成；预后

英文关键词：

• 摘要：

• 【摘要】目的    探讨重症烧伤患者应用重组人生长激素（rhGH）治疗对相关指标及治疗效果的影响。方法    选取2014年2月至2016年4月于空军军医大学第一附属医院诊治的重症烧伤患者102例，按照随机数字表法分为观察组和对照组，各51例。2组患者入院后均择期行手术治疗，对照组患者从术后第1天开始，在常规护理和用药的基础上，给予2 ml 0.9%氯化钠注射液安慰剂治疗，共持续10 d；观察组患者从术后第1天开始，在常规护理和用药的基础上，每日睡前皮下注射rhGH，共持续10 d。比较2组患者手术前后生长激素、皮质醇、血糖、胰岛素、胰高血糖素水平及术后血浆前白蛋白、血浆总蛋白水平和供皮区、植皮区、深Ⅱ度烧伤区痂下愈合时间及住院时间。结果    观察组在术后3 d开始生长激素水平明显高于对照组，差异均有统计学意义（均P＜0.05）。观察组血糖和胰岛素水平分别在术后3 d和7 d开始明显高于对照组，差异均有统计学意义（均P＜0.05）。术后7、10、15 d，观察组血浆前白蛋白和总蛋白水平均明显高于对照组，差异均有统计学意义（均P＜0.05）。观察组供皮区、植皮区、深Ⅱ度烧伤区痂下愈合时间和住院时间均明显短于对照组［（8.8±2.5）d比（13.4±2.7）d、（25±6）d比（37±9）d、（21±3）d比（29±4）d、（51±6）d比（69±9）d］，差异均有统计学意义（均P＜0.05）。结论    重症烧伤患者应用rhGH治疗能改善机体代谢水平，促进蛋白合成，加速创口愈合，缩短治疗时间。

• 【Abstract】Objective    To explore the effect of recombinant human growth hormone（rhGH） on severe burn patients. Methods    Totally 102 cases of severe burn patients undergoing selective surgery were enrolled at the First Affiliated Hospital of Air Force Medical University from February 2014 to April 2016. The patients were randomly divided into observation group and control group, with 51 cases in each group. On the basis of routine medication and nursing after surgery, the control group was given 2 ml 0.9% sodium chloride injection as placebo and the observation group was given subcutaneous injection of rhGH before bedtime for 10 days. Levels of growth hormone, cortisol, blood sugar, insulin, glucagon, prealbumin and total protein, subeschar healing time of donor site, skin graft and deep second-degree burn area, and length of hospital stay were analyzed. Results    Growth hormone level significantly increased in the observation group since 3 days after surgery compared to that in the control group(P＜0.05). Levels of blood sugar and insulin in the observation group were significantly higher compared to those in the control group since 3 days and 7 days after surgery(all P＜0.05). At 7, 10, 15 days after surgery, levels of plasma prealbumin and total protein in the observation group were significantly higher than those in the control group(all P＜0.05). Healing time of donor site, skin graft and deep second-degree burn and hospitalization time in the observation group were significantly shorter than those in the control group［（8.8±2.5）d vs （13.4±2.7）d, （25±6）d vs （37±9）d, （21±3）d vs （29±4）d, （51±6）d vs （69±9）d］(all P＜0.05). Conclusion    RhGH treating severe burn can improve body metabolism, promote protein synthesis, accelerate wound healing and shorten the cure time.