作　　者： ; ; ; ; ; ; ;

机构地区： 第四军医大学唐都医院

出　　处： 《中华烧伤杂志》 2007年第4期292-295,共4页

摘　　要： 目的观察封闭负压引流(VAC)技术对猪爆炸伤感染创面肉芽组织毛细血管新生的影响。方法用电雷管在4只小白家猪双侧肩胛及双侧臀部各造成1个面积为(7.3±1.0)cm^2爆炸伤创面,按完全随机化方法分为对照组(8个创面)和治疗组(8个创面)。两组均在伤后2 d行创面处理。对照组:创面清创后覆盖单层油纱;治疗组:清创后用VAC治疗。各组均于处置前及处置后1、3、6 d切取2 mm×2 mm×2 mm的创面组织行病理切片。光学显微镜下观察周皮细胞的分化、Image C软件行毛细血管管腔面积计算及图像处理。结果对照组处置前及处置后1、3 d,创面毛细血管较少,且血管内皮细胞周围缺少周皮细胞包裹;处置后6 d毛细血管增多,有少量周皮细胞包裹。治疗组处置后1 d毛细血管增加,并有充足的周皮细胞包裹;此后有周皮细胞包裹的毛细血管逐渐增多。治疗组处置后1、3、6 d创面内结蛋白阳性颗粒吸光度值(2569±330、3984±377、9611±960)均高于对照组(91±54、199±85、1552±298,P<0.01)。对照组处置后1、3、6 d毛细血管管腔总面积较小,分别为[(59±36)、(250±70)、(938±287)·μm^2],均小于治疗组[(818±234)、(4518±1080)、(9058±1656)μm^2,P<0.01]。结论与常规换药相比,VAC不仅能使猪皮肤软组织爆炸伤感染创面肉芽组织内新生毛细血管形成,还能促进周皮细胞分化,增加毛细血管管腔面积。 Objective To investigate the influence of vacuum-assisted closure （VAC） technique on the growth of capillaries in the wound of the pig produced by explosion. Methods Four small white pigs were inflicted with 16 explosion wounds[ （7.3 ± 1.0） cm^2 in area] on both sides of the buttocks, shoulders and hips by detonation of a specific type of explosive , and the wounds were randomly divided into 2 groups, i. e, control（C, with conventional treatment from 2 post-injury day（PID） on and treatment（T, with VAC treatment after debridement from 2 PID on） groups, with 8 wounds in each group. Wound tissues of2mm × 2mm × 2mm in size were harvested for pathological examination before treatment and on 1 and 3 post-treatment day（PTD）. The differentiation of adventitial cells were examined with light microscope, and the pixel value of desmin positive particles and the luminal area of newly formed capillaries were assessed with Image C software. Results Most of vessels in the wound of both groups were in elliptic shape when observed in longitudinal＇section. In C group, few newly formed capillaries vessels with lack of perieytes were observed before treatment and on 1, 3 PTD, then the number began to increase on 6 PTD. In T group, the number of newly formed capillaries with perieytes was increased on 1 PTD, and it continued to increase thereafter. The pixel values of desmin positive particles in C group on 1, 3, and 6 PTD were （91 ±54） , （ 199 ±85） , and （1552 ±298） , respectively, which were obviously higher than those in T group[ （2569 ± 330）, （3984 ± 377）,（9611 ±960）, P 〈0.01]. The area of vessel lumen in C group was （59 ±36）, （250±70）, and （938 ±287）μm^2 ,respectively on 1, 3, and 6 PTD, which was also smaller than those in T group[ （818 ± 234）, （4518±1080）, and （9058±1656）μm^2, P 〈0.01]. Conclusion Compared with conventional therapy, VAC can not only accelerate the formation of new capillaries, but also enhance the diff

关 键 词： 感染 伤口愈合 爆震伤 负压引流

领　　域： [农业科学] [农业科学] [农业科学]