低温等离子技术治疗猪感染创面的实验研究  

An experimental study of low temperature plasma technology for the treatment of infected wounds in minipigs

作　　者：左坦坦[1] 杨润功[2] 郑稼[1] 朱加亮[2] 张宇鹏[2] 侯树勋[2] 

机构地区：[1]河南省人民医院骨科,河南郑州450003 [2]中国人民解放军总医院第一附属医院骨科,北京100048

出　　处：《实用手外科杂志》2013年第3期377-381,387,共6页Journal of Practical Hand Surgery

基　　金：基金项目：北京市科技计划课题（项目编号：Z111107058811099）

摘　　要：目的观察低温等离子技术对小型猪感染创面的疗效。方法选取小型猪制成全层皮肤缺损感染创面的动物模型。将160个感染创面随机分为四组：等离子病灶清除组、电刀病灶清除组、锐器病灶清除组以及对照组．分别用等离子射频技术、电刀、普通刀片对创面进行病灶清除，对照组不处理。分别于术后0，2，7，14d观察各创面的愈合率、组织填充率、细菌定量检查、组织学检查等指标，记录创面完全愈合所需的时间并进行统计学分析。结果160个创面接种金黄色葡萄球菌稀释液后48h，均制成感染性创面。四种处理方式术后创面即时有所不同：低温等离子治疗后创面出血少，创面新鲜、平整、无异物存留；电刀病灶清除后创面出血较少，但有炭化组织，创面较新鲜；锐器病灶清除后创面出血较多。需纱布压迫止血．创面新鲜，有数个压迫止血后的凝血点。术后各组在2d和7d时，创面面积均较术前缩小、组织充填率均不同程度提高、细菌数量均有所减少。术后14d时，各组的创面愈合率差异有显著性（P〈0．05）：各组创面的组织充填率均达到100％，对照组仅为（84％±8％）；各组的创面完全愈合时间比较差异有显著性（P〈0．05）。等离子组愈合时间最短，细菌计数在0，2，7，14d时，均较其他各组减少，差异有显著性（P〈0．05）。术后14d病理检查结果示：各组创面的新生真皮内均存在不同程度的炎性细胞浸润，以对照组最重，等离子组最轻；等离子组新生上皮较厚，胶原束较致密，电刀组和锐器组次之。对照组最差。结论低温等离子技术能有效去除感染创面的坏死组织，创面细菌数量显著减少，提高创面愈合率．进而缩短创面的愈合时间。Objective To observe the clinical outcomes of low temperature plasma technology for the treatment of infected wounds in minipigs. Methods Infected wounds of full-thickness skin defects were prepared in minipigs. All wounds were divided into 4 groups randomly： the low temperature plasma ablation group, the bipolar electrocautery system group, the sharp debridement group and the control group. The healing rate, healing time, tissue filling rate, bacterial quantitative examination, histological examination etc of each group were observed postoperatively on the day 0, 2, 7 and 14. Results 160 infected wounds were made after 48 hours, which were inoculated with Staphylococcus aureus dilution. The wounds after low temperature plasma treatment were bleeding slight, which were fresh and flat; The wounds after electric knife debridement were also bleeding slight, which were fresh due to the tissue carbonization caused by the high temperature; The wounds after sharp debridement were bleeding more and needed more gauze to stop it, which were fresh but with several coagulation points after compression hemostasis. On the 2nd and 7th day after the operation, the wound area was reduced; tissue filling rateswere improved in different degrees; and the number of bacteria decreased. On the 14th day after the operation, there was significant difference between the four groups （P〈0.05）; the tissue filling rate ofwounds was nearly 100% in each debridement group, which was worst in the control group （84%）; we found the significant differences between the four groups（P〈0.05）. On the 0, 2nd, 7th, and 14th day after postoperation, the bacterial counts of the plasma debridement group significantly decreased comparing with the rest of the three groups （P〈0.05）. The results of pathological examination on the 14th day after the operation showed： there was inflammatory cell infiltration in varying degrees in neonatal dermis of all wounds, which was most serious in the control group, and lightest in the plasma debridem

关 键 词：创面愈合 感染 病灶清除 低温等离子消融术 

分 类 号：R697.32[医药卫生—泌尿科学]