Efficacy of Propranolol in Wound Healing for Hospitalized Burn Patients
Efficacy of Propranolol in Wound Healing for Hospitalized Burn Patients
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DOI：
10.1097/bcr.0b013e3181b48600
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发表时间：
2009-11-01
影响因子：
1.4
通讯作者：
Mohammadi, Mohammad Kazem
中科院分区：
文献类型：
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作者：
Mohammadi, Ali Akbar;Bakhshaeekia, Alireza;Mohammadi, Mohammad Kazem
烧伤患者在危重或受伤患者中代谢率最高。由于普萘洛尔能降低能量消耗和肌肉蛋白质代谢，在本研究中，我们假设普萘洛尔能改善愈合过程，缩短伤口愈合时间。本研究是一项双盲随机临床试验; 2006年1月至2007年1月期间，共有79名烧伤患者转诊至该中心，符合纳入标准。普萘洛尔组37例，对照组42例。普萘洛尔组口服普萘洛尔1 mg/kg/d，最大剂量1.98mg/kg/d，分6次给药。调整该剂量以使每例患者的静息心率从基线值降低20%。对照组给予安慰剂。两组中最常见的烧伤原因是火焰，其次是闪光。普萘洛尔组的浅表烧伤患者需要更少的时间来愈合可接受的浅表烧伤伤口愈合（16.13 +/- 7.40天vs 21.52 +/- 7.94天; P = 0.004）。我们还发现，与对照组相比，深度烧伤患者准备植皮所需的时间更少（28.23 +/- 8.43天vs 33.46 +/- 9.17天; P = 0.007）。普萘洛尔的使用减小了最终需要植皮的烧伤创面的大小。普萘洛尔组患者平均烧伤面积为31.42%TBSA，最终需植皮面积为13.75%TBSA，对照组患者平均烧伤面积为33.61%TBSA，最终需植皮面积为18.72%TBSA。对照组患者平均烧伤面积为33.61%TBSA，最终需要植皮的TBSA为18.72%（P = 0.006）。普萘洛尔组患者的住院时间短于对照组（30.95 +/- 8.44天vs 24.41 +/- 8.11天; P = 0.05）。给予普萘洛尔可改善烧伤创面愈合，缩短愈合时间和住院时间。普萘洛尔的使用减少了需要植皮的伤口表面积。（J Burn Care Res 2009;30：1013-1017）
Burn patients have the highest metabolic rate among critically ill or injured patients. Because propranolol decreases energy expenditure and muscle protein catabolism, in this study, we hypothesized that propranolol would improve healing process and decrease wound-healing time. This study was a double-blind randomized clinical trial; a total of 79 burn patients who referred to this center from January 2006 to January 2007 fulfilled the inclusion criteria. Thirty-seven patients were randomly placed in propranolol group and 42 in control group. The propranolol group received propranolol orally with the dose of 1 mg/kg/d and maximum dose of 1.98 mg/kg/d given in six divided doses. This dose was adjusted to decrease the resting heart rate by 20% from each patient's baseline value. The control group received placebo. The most common cause of burn in both groups was flame followed by flash. Patients with superficial burns in the propranolol group needed less time to heal for acceptable wound healing in superficial burns (16.13 +/- 7.40 days vs 21.52 +/- 7.94 days; P = .004). We also found that patients with deep burn injury needed less time to be ready for skin graft (28.23 +/- 8.43 days vs 33.46 +/- 9.17 days; P = .007) when compared to that of the control group. The use of propranolol decreased the size of the burn wound that finally needed skin graft. Patients in the propranolol group with an average burn size of 31.42% TBSA finally needed 13.75% of TBSA skin graft compared with that of control patients with an average burn size of 33.61% TBSA who needed 18.72% of TBSA skin graft, and patients in the control group with an average burn size of 33.61% TBSA finally needed 18.72% of TBSA skin graft (P = .006). Patients in the propranolol group had a shorter hospital stay period than the control group (30.95 +/- 8.44 days vs 24.41 +/- 8.11 days; P = .05). Administration of propranolol, improved burn wound healing, and decreased healing time and hospital stay period. The use of propranolol decreased the surface area of wounds that needed to be skin grafted. (J Burn Care Res 2009;30:1013-1017)