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封閉負壓引流術通過增加傷口組織中NGF表達和微血管數(shù)量促進慢性創(chuàng)面愈合

發(fā)布時間:2018-05-11 17:18

  本文選題:封閉負壓引流 + 神經生長因子; 參考:《蘭州大學》2013年碩士論文


【摘要】:目的研究封閉負壓引流技術(Vacuum Sealing Drainage, VSD)對人慢性創(chuàng)面創(chuàng)周組織中NGF表達及微血管數(shù)量的影響,探索促進慢性創(chuàng)面愈合的機制。 方法以我院2011-3至2012-6收治的10例慢性創(chuàng)面患者為研究對象,其中胸部軟組織缺損、骨髓炎伴骨外露和截肢術后殘端大面積皮膚缺損各1例、皮膚撕脫傷后創(chuàng)面感染2例、脛骨骨髓炎2例、術后傷口感染3例。分別于VSD吸引前、吸引7天和14天切取創(chuàng)周皮膚和創(chuàng)面內肉芽組織,采用免疫組織化學技術檢測NGF的表達和微血管數(shù)量的變化,并觀察傷口情況。 結果1、VSD治療7天和14天后成纖維細胞及血管內皮細胞中的NGF表達明顯高于治療前(P0.001) 2、VSD治療使微血管數(shù)量從治療前1.3±1.2增加到治療第7天的3.4±1.3(P0.05)和第14天的4.9±2.0(P0.01)。 3、VSD治療前創(chuàng)基內肉芽組織量少且較晦暗,存在壞死組織和較多膿性分泌物,傷口周圍組織腫脹明顯。經VSD治療后,傷口內壞死組織和膿性分泌物逐漸減少,肉芽組織呈細顆粒狀,鮮紅色,觸之易出血,傷口周圍腫脹減輕。 結論封閉負壓引流技術可以提高慢性創(chuàng)面創(chuàng)周組織中NGF的表達和微血管數(shù)量,促進創(chuàng)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 鹵1.2 before treatment to 3.4 鹵1.3 P0.05 on the 7th day and 4.9 鹵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.
【學位授予單位】:蘭州大學
【學位級別】:碩士
【學位授予年份】:2013
【分類號】:R641

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