封闭负压引流术通过增加伤口组织中NGF表达和微血管数量促进慢性创面愈合

发布时间：2018-05-11 17:18

本文选题：封闭负压引流 + 神经生长因子　；参考：《兰州大学》2013年硕士论文

【摘要】：目的研究封闭负压引流技术(Vacuum Sealing Drainage, VSD)对人慢性创面创周组织中NGF表达及微血管数量的影响,探索促进慢性创面愈合的机制。方法以我院2011-3至2012-6收治的10例慢性创面患者为研究对象,其中胸部软组织缺损、骨髓炎伴骨外露和截肢术后残端大面积皮肤缺损各1例、皮肤撕脱伤后创面感染2例、胫骨骨髓炎2例、术后伤口感染3例。分别于VSD吸引前、吸引7天和14天切取创周皮肤和创面内肉芽组织,采用免疫组织化学技术检测NGF的表达和微血管数量的变化,并观察伤口情况。结果1、VSD治疗7天和14天后成纤维细胞及血管内皮细胞中的NGF表达明显高于治疗前(P0.001) 2、VSD治疗使微血管数量从治疗前1.3±1.2增加到治疗第7天的3.4±1.3(P0.05)和第14天的4.9±2.0(P0.01)。 3、VSD治疗前创基内肉芽组织量少且较晦暗,存在坏死组织和较多脓性分泌物,伤口周围组织肿胀明显。经VSD治疗后,伤口内坏死组织和脓性分泌物逐渐减少,肉芽组织呈细颗粒状,鲜红色,触之易出血,伤口周围肿胀减轻。结论封闭负压引流技术可以提高慢性创面创周组织中NGF的表达和微血管数量,促进创面愈合。
[Abstract]:Objective to study the effect of vacuum Sealing Drainage, VSD) on the expression of NGF and the number of microvessels in the wound tissues of chronic wounds, and to explore the mechanism of promoting the healing of chronic wounds. Methods Ten patients with chronic wound were treated in our hospital from March 2011 to June 2012, including chest soft tissue defect, large area skin defect after osteomyelitis with bone exposure and amputation, and wound infection after skin avulsion. Tibial osteomyelitis 2 cases, postoperative wound infection 3 cases. The granulation tissue of wound skin and wound were cut on the 7th and 14th day before VSD attraction. The expression of NGF and the change of microvessel quantity were detected by immunohistochemical technique, and the wound condition was observed. Results 1 the expression of NGF in fibroblasts and vascular endothelial cells after 7 and 14 days of VSD treatment was significantly higher than that in pretreatment (P 0.001). 2VSD increased the number of microvessels from 1.3 卤1.2 before treatment to 3.4 卤1.3 P0.05 on the 7th day and 4.9 卤2.0 P0.01on the 14th day. (3) before VSD treatment, the amount of granulation tissue was less and dark, there were necrotic tissue and more purulent secretions, and the tissue around the wound was swollen obviously. After treatment with VSD, necrotic tissue and purulent secretion gradually decreased, granulation tissue was fine granular, bright red, bleeding easily and swelling around the wound was alleviated. Conclusion sealing negative pressure drainage technique can improve the expression of NGF and the number of microvessels in the wound tissue of chronic wound and promote wound healing.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R641

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