切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2025, Vol. 20 ›› Issue (04) : 277 -283. doi: 10.3877/cma.j.issn.1673-9450.2025.04.001

所属专题: 指南共识

指南与共识

生长因子在Ⅱ度烧伤创面治疗中应用专家共识(2024版)
《生长因子在Ⅱ度烧伤创面治疗中应用专家共识(2024版)》编写组   
  • 收稿日期:2025-02-26 出版日期:2025-08-01
  • 基金资助:
    国家自然科学基金面上项目(82472587)

Expert consensus on the application of growth factors in the treatment of second-degree burn wounds (2024 version)

Working Group of Expert Consensus on the Application of Growth Factors in the Treatment of Second-Degree Burn Wounds (2024 version)   

  • Received:2025-02-26 Published:2025-08-01
引用本文:

《生长因子在Ⅱ度烧伤创面治疗中应用专家共识(2024版)》编写组. 生长因子在Ⅱ度烧伤创面治疗中应用专家共识(2024版)[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 277-283.

Working Group of Expert Consensus on the Application of Growth Factors in the Treatment of Second-Degree Burn Wounds (2024 version). Expert consensus on the application of growth factors in the treatment of second-degree burn wounds (2024 version)[J/OL]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2025, 20(04): 277-283.

Ⅱ度烧伤是临床中常见的烧伤类型,目前多种敷料、外用药物等均可促进Ⅱ度烧伤创面愈合,其中生长因子通过促进细胞增殖、迁移和分化,以及增强血管生成和胶原合成等,协同作用于创面愈合过程。虽然生长因子制剂已在临床应用多年,但随着新的生长因子种类和剂型的出现,相关争议也较为突出。如何选择合适的生长因子并及时有效地应用于烧伤创面治疗,是临床应用中的难题。该文汇集了烧伤及相关领域专家在生长因子用于Ⅱ度烧伤创面的使用种类、应用范围、使用时机以及瘢痕防治等方面达成的共识,旨在为生长因子在Ⅱ度烧伤创面治疗中的应用提供指导性建议。

Second-degree burns are a common type of burn in clinical practice. Currently, multiple types of dressings and topical medications can promote the healing of second-degree burn wounds. Among these, growth factors play a synergistic role in the wound healing process by promoting cell proliferation, migration, and differentiation, as well as enhancing angiogenesis and collagen synthesis. Although growth factor preparations have been used in clinical practice for many years, the emergence of new types and formulations of growth factors led to more prominent related controversies. How to select appropriate growth factors and apply timely and effectively for the treatment of burn wounds is a challenge in clinical application. This article compiles the consensus reached by experts in the field of burns and related areas on the use of growth factors for second-degree burn wounds, including the types, application scope, usage duration, and scar prevention, aiming to provide guiding recommendations for the use of growth factors in the treatment of second-degree burn wounds.

表1 2001版牛津大学循证医学中心证据分级标准
[1]
Ji SZLuo PFKong ZD, et al.Pre-hospital emergency burn management in Shanghai: analysis of 1868 burn patients[J]. Burns201238(8): 1174-1180.
[2]
中华医学会烧伤外科学分会,《中华烧伤杂志》编辑委员会.皮肤创面外用生长因子的临床指南[J]. 中华烧伤杂志201733(12): 721-727.
[3]
中华医学会烧伤外科学分会,海峡两岸医药卫生交流协会暨烧创伤组织修复专委会.Ⅱ度烧伤创面治疗专家共识(2024版)Ⅰ:院前急救和非手术治疗[J]. 中华烧伤与创面修复杂志202440(1): 1-18.
[4]
Wenczak BALynch JBNanney LB.Epidermal growth factor receptor distribution in burn wounds. Implications for growth factor-mediated repair[J]. J Clin Invest199290(6): 2392-2401.
[5]
Carpenter GCohen S.Epidermal growth factor[J]. Annu Rev Biochem197948: 193-216.
[6]
Kwon YBKim HWRoh DH, et al.Topical application of epidermal growth factor accelerates wound healing by myofibroblast proliferation and collagen synthesis in rat[J] . J Vet Sci20067(2): 105-109.
[7]
Laplante MSabatini DM.mTOR signaling in growth control and disease[J]. Cell2012149(2): 274-293.
[8]
Kalay ZCevher SC.Oxidant and antioxidant events during epidermal growth factor therapy to cutaneous wound healing in rats[J]. Int Wound J20129(4): 362-371.
[9]
付小兵,孙晓庆,孙同柱,等.表皮细胞生长因子通过诱导皮肤干细胞分化加速受创表皮再生的研究[J]. 中国修复重建外科杂志200216(1): 31-35.
[10]
Barrientos SStojadinovic OGolinko MS, et al.Growth factors and cytokines in wound healing[J]. Wound Repair Regen200816(5): 585-601.
[11]
Pastar IStojadinovic OYin NC, et al.Epithelialization in wound healing: a comprehensive review[J]. Adv Wound Care(New Rochelle)20143(7): 445-464.
[12]
Citri AYarden Y.EGF-ERBB signalling: towards the systems level[J]. Nat Rev Mol Cell Biol20067(7): 505-516.
[13]
García-Ojalvo ABerlanga Acosta JFigueroa-Martínez A, et al. Systemic translation of locally infiltrated epidermal growth factor in diabetic lower extremity wounds[J]. Int Wound J201916(6): 1294-1303.
[14]
Cohen S.Isolation of a mouse submaxillary gland protein accelerating incisor eruption and eyelid opening in the new-born animal[J]. J Biol Chem1962237: 1555-1562.
[15]
Das RVirlan MJRXenaki V, et al.Granulocyte macrophage-colony stimulating factor and keratinocyte growth factor control of early stages of differentiation of oral epithelium[J]. Eur J Oral Sci2022130(3): e12867.
[16]
Fang YGong SJXu YH, et al.Impaired cutaneous wound healing in granulocyte/macrophage colony-stimulating factor knockout mice[J]. Br J Dermatol2007157(3): 458-465.
[17]
Cantürk NZEsen NVural B, et al.The relationship between neutrophils and incisional wound healing[J]. Skin Pharmacol Appl Skin Physiol200114(2): 108-116.
[18]
Kim MHLiu WBorjesson DL, et al.Dynamics of neutrophil infiltration during cutaneous wound healing and infection using fluorescence imaging[J]. J Invest Dermatol2008128(7): 1812-1820.
[19]
Postiglione LMontagnani SRiccio A, et al.Expression of GM-CSF receptor and "in vitro" effects of GM-CSF on human fibroblasts[J]. Life Sci199863(5): 327-336.
[20]
Postiglione LLadogana PMontagnani S, et al.Effect of granulocyte macrophage-colony stimulating factor on extracellular matrix deposition by dermal fibroblasts from patients with scleroderma[J]. J Rheumatol200532(4): 656-664.
[21]
Mann ANiekisch KSchirmacher P, et al.Granulocyte-macrophage colony-stimulating factor is essential for normal wound healing[J]. J Investig Dermatol Symp Proc200611(1): 87-92.
[22]
Bennett SPGriffiths GDSchor AM, et al.Growth factors in the treatment of diabetic foot ulcers[J]. Br J Surg200390(2): 133-146.
[23]
Wu LPierce GFGaliano RD, et al.Keratinocyte growth factor induces granulation tissue in ischemic dermal wounds. Importance of epithelial-mesenchymal cell interactions[J]. Arch Surg1996131(6): 660-666.
[24]
Ceccarelli SCardinali GAspite N, et al.Cortactin involvement in the keratinocyte growth factor and fibroblast growth factor 10 promotion of migration and cortical actin assembly in human keratinocytes[J]. Exp Cell Res2007313(9): 1758-1777.
[25]
Gallucci RMSloan DKHeck JM, et al.Interleukin 6 indirectly induces keratinocyte migration[J]. J Invest Dermatol2004122(3): 764-772.
[26]
Barrientos S, Brem H, Stojadinovic O, et al. Clinical application of growth factors and cytokines in wound healing[J]. Wound Repair Regen, 2014, 22(5): 569-578.
[27]
Wei YLi JHuang Y, et al.The clinical effectiveness and safety of using epidermal growth factor, fibroblast growth factor and granulocyte-macrophage colony stimulating factor as therapeutics in acute skin wound healing: a systematic review and meta-analysis[J]. Burns Trauma202210: tkac002.
[28]
周亮,王世岭,马建丽,等.重组人表皮生长因子外用治疗烧伤创面的多中心研究[J]. 中国新药与临床杂志200120(5): 337-340.
[29]
林源,张立明,王润秀,等.外用冻干重组人表皮生长因子促进创面愈合的疗效观察[J]. 广西医科大学学报200219(3): 351-352.
[30]
雄婉玲.重组人表皮生长因子凝胶在儿童浅Ⅱ度烧伤创面中的疗效研究[J]. 中国医药指南201816(34): 138.
[31]
过云,虞俊杰,吕国忠.外用重组人表皮生长因子凝胶治疗浅Ⅱ度烧伤创面的临床观察[J]. 中华损伤与修复杂志(电子版)20094(6): 683-687.
[32]
Fu XShen ZChen Y, et al.Recombinant bovine basic fibroblast growth factor accelerates wound healing in patients with burns, donor sites and chronic dermal ulcers[J]. Chin Med J (Engl)2000113(4): 367-371.
[33]
Fu XShen ZChen Y, et al.Randomised placebo-controlled trial of use of topical recombinant bovine basic fibroblast growth factor for second-degree burns[J]. Lancet1998352(9141): 1661-1664.
[34]
Zhang YWang THe J, et al.Growth factor therapy in patients with partial-thickness burns: a systematic review and meta-analysis[J]. Int Wound J201613(3): 354-366.
[35]
张兵,徐海.含重组人表皮细胞生长因子面膜促进面部深Ⅱ度烧伤创面愈合的临床观察[J]. 中华损伤与修复杂志(电子版)20116(4): 586-590.
[36]
王光毅,夏照帆,朱世辉,等.应用表皮生长因子治疗深Ⅱ度烧伤创面的远期临床疗效观察[J]. 中华烧伤杂志200319(3): 167-168.
[37]
郑中柱,刘杰锋,谢卫国,等.重组人表皮细胞生长因子在小儿Ⅱ度烧伤创面的应用[J]. 华中科技大学学报(医学版)200332(6): 667-668.
[38]
Zhang LChen JHan C.A multicenter clinical trial of recombinant human GM-CSF hydrogel for the treatment of deep second-degree burns[J]. Wound Repair Regen200917(5): 685-689.
[39]
Yan DLiu SZhao X, et al.Recombinant human granulocyte macrophage colony stimulating factor in deep second-degree burn wound healing[J]. Medicine (Baltimore)201796(22): e6881.
[40]
Li JLiu WZhang G, et al.Effectiveness of recombinant human granulocyte macrophage colony-stimulating factor for treating deep second-degree burns: a systematic review and meta-analysis[J]. BMJ Mil Health2020166(5): 352-357.
[41]
刘健,廖镇江,张勤.外用重组人粒细胞巨噬细胞集落刺激因子凝胶制剂治疗深Ⅱ度烧伤创面Ⅳ期临床研究[J]. 中华烧伤杂志201632(9): 542-548.
[42]
Ma BCheng DSXia ZF, et al.Randomized, multicenter, double-blind, and placebo-controlled trial using topical recombinant human acidic fibroblast growth factor for deep partial-thickness burns and skin graft donor site[J]. Wound Repair Regen200715(6): 795-799.
[43]
柴家科,孙永华,夏照帆,等.酸性成纤维细胞生长因子治疗深Ⅱ度烧伤的多中心随机对照临床试验[J]. 中国药师201518(4): 589-591.
[44]
Zhan DCShen YSZhao YR, et al.Efficacy and safety of basic fibroblast growth factor in the treatment of burns: protocol for a systematic review and meta-analysis of randomized controlled trials[J]. Medicine (Baltimore)201998(14): e15102.
[45]
中华医学会烧伤外科学分会.磨痂术在烧伤创面中的临床应用全国专家共识(2021版)[J]. 中华烧伤杂志202137(6): 501-507.
[46]
王德昌,赵冉.重视磨痂术在早期深Ⅱ度烧伤创面的应用[J]. 中华烧伤杂志202036(6): 506-509.
[47]
王振君,仇佩庆,彭丽丽,等.头面部深Ⅱ度烧伤的磨痂治疗疗效分析[J]. 浙江临床医学201618(2): 286-287.
[48]
陈璧.深Ⅱ度烧伤创面治疗与愈合后的关系[J]. 中华烧伤杂志200521(1):9-11.
[49]
Abdelhakim MLin XOgawa R.The Japanese experience with basic fibroblast growth factor in cutaneous wound management and scar prevention: a systematic review of clinical and biological aspects[J]. Dermatol Ther (Heidelb)202010(4): 569-587.
[50]
Hayashida KAkita S.Quality of pediatric second-degree burn wound scars following the application of basic fibroblast growth factor: results of a randomized, controlled pilot study[J]. Ostomy Wound Manage201258(8): 32-36.
[51]
Chi YFChai JKLuo HM, et al.Safety of recombinant human granulocyte-macrophage colony-stimulating factor in healing pediatric severe burns[J]. Genet Mol Res201514(1): 2735-2741.
[52]
Akita SAkino KImaizumi T, et al.Basic fibroblast growth factor accelerates and improves second-degree burn wound healing[J]. Wound Repair Regen200816(5): 635-641.
[53]
Akita SAkino KImaizumi T, et al.The quality of pediatric burn scars is improved by early administration of basic fibroblast growth factor[J]. J Burn Care Res200627(3): 333-338.
[54]
侯琪,黄俊,徐华康,等.烧伤休克期液体复苏有创监测指标的利与弊[J]. 中国美容整形外科杂志202435(11): 688-691.
[55]
张丕红,张怡坤,梁鹏飞.烧伤科主导的综合重症监护病房救治危重烧伤的临床实践和模式探讨[J]. 中华烧伤与创面修复杂志202440(12):1107-1113.
[56]
王配合,齐顺贞,彭毅志.表皮细胞生长因子和碱性成纤维细胞生长因子促进烧伤创面愈合的疗效比较[J]. 临床军医杂志200432(2): 35-37.
[57]
张琛,洪树伟,顾翠,等.重组牛碱性成纤维细胞生长因子治疗Ⅱ度烧伤创面的临床观察[J]. 中华烧伤杂志200117(4): 246.
[58]
Jelinek DZhang ERAmbrus A, et al.A mouse model to investigate the role of cancer-associated fibroblasts in tumor growth[J]. J Vis Exp2020166: 10.3791/e61883.
[59]
Li CKuang KDu J, et al.Far beyond anti-angiogenesis: benefits for anti-basicFGF therapy in cancer[J]. Biochim Biophys Acta Mol Cell Res20221869(7): 119253.
[1] 黄书润, 阮明珍, 陈蓝, 苏惠强, 刘丁井, 曾纯. 采用改良腹部带蒂皮瓣修复手部严重烧创伤创面的临床效果[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 284-289.
[2] 王献珍, 王洪瑾, 李毅, 崔强. 青海省某三甲医院烧伤住院患者流行病学特征分析[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 312-317.
[3] 戴昕吭, 余婷, 王园, 李雅鑫, 吴尉, 吴敏, 何俊生, 肖仕初. 烧伤科护士吸入性损伤气道护理能力的潜在类别及影响因素分析[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 318-324.
[4] 杨磊, 王晶晶, 陈辉, 赵春月, 赵筱卓, 藏琳琳, 胡骁骅. 单纯面颈部烧伤或大面积烧伤合并吸入性损伤患者颈部水肿程度的变化规律分析[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(04): 333-338.
[5] 李培真, 刘海亮, 李大伟, 贾昊, 张泽瑾, 刘力维, 申传安. 重度烧伤患者发生早期急性肾损伤危险因素分析及预测模型建立[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 199-205.
[6] 余婷, 戴昕吭, 王园, 李雅鑫, 冯苹, 何俊生, 肖仕初, 伍国胜. 大面积烧伤创面动静脉置管及维护策略的构建[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 220-226.
[7] 贾昊, 刘兆兴, 李大伟, 李培真, 张泽瑾, 刘力维, 申传安. 高迁移率族蛋白B1 在严重烧伤延迟复苏大鼠肝损伤中的作用[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 241-247.
[8] 李文池, 沈拓. 光动力治疗在创面修复中应用的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 248-253.
[9] 张泽瑾, 李大伟, 李於聪, 刘兆兴, 申传安. 烧伤休克液体复苏的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 254-259.
[10] 黄洲龙, 张金丽, 周日兴, 于昊, 张志. 巨噬细胞向肌成纤维细胞转分化在纤维化疾病中作用的研究进展[J/OL]. 中华损伤与修复杂志(电子版), 2025, 20(03): 271-275.
[11] 中华医学会外科学分会腹腔镜与内镜外科学组, 中国抗癌协会胃癌专业委员会, 中国抗癌协会腔镜与机器人外科分会, 《中华消化外科杂志》编辑委员会. 精准外科胃癌转化治疗专家共识(2025 版)[J/OL]. 中华普通外科学文献(电子版), 2025, 19(03): 145-156.
[12] 王淼, 贺佳佳, 潘颖威, 王小兰, 姚袆, 刘明宝, 陆兮, 苏丽洁. 远端胆管癌术后生存预后及其影响因素分析[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(04): 582-588.
[13] 中国NOSES联盟, 中国医师协会结直肠肿瘤专业委员会NOSES学组, 中国医师协会结直肠肿瘤专业委员会机器人手术学组, 中国抗癌协会NOSES专业委员会. “机器人”结直肠肿瘤经自然腔道取标本手术专家共识(2025版)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(03): 202-220.
[14] 刘姗姗, 赵晓娇, 乔玉峰. 通过干预转化生长因子-β/哺乳动物母体抗十五肢体瘫痪蛋白经典信号通路防治肾脏纤维化的研究进展[J/OL]. 中华肾病研究电子杂志, 2025, 14(03): 158-163.
[15] 冯欣, 尤素伟, 史晓梅, 王相斌, 巩巧丽, 王俊英. 血清VEGF-A、HIF-1α、MIF水平与急性脑梗死并发脑心综合征的关联性研究[J/OL]. 中华脑血管病杂志(电子版), 2025, 19(03): 213-219.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?