负压创面治疗对烧伤创面脓毒症小鼠死亡率的影响  

Effect of Negative Pressure Wound Therapy on Mortality of Burn Wound Sepsis in Mice

作　　者：刘洋[1] 胡大海[1] 董茂龙[1] 白晓智[1] 李小强[1] 

机构地区：[1]第四军医大学西京医院全军烧伤中心烧伤与皮肤外科,西安710032

出　　处：《解放军医药杂志》2013年第12期16-19,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省卫生厅科研基金(2012k18-01-06)

摘　　要：目的观察负压创面治疗(NPWT)对烧伤创面脓毒症小鼠死亡率的影响。方法健康雄性C57小鼠108只,60只按随机数字表法分为对照组和实验组,建立烫伤后感染模型,实验组行NPWT治疗,对照组用无菌生理盐水湿敷(WTD)治疗。观察小鼠创面细菌荧光表达量、脏器病理改变情况。其余48只按随机数字表法分为烫伤组、烫伤感染组、烫伤感染NPWT处理组和烫伤感染换药组,进行7 d生存分析。结果实验组小鼠创面细菌荧光强度1、3、5 d时均显著低于对照组(P<0.01),器官病理反应轻于对照组。7 d生存率烫伤感染NPWT组显著高于烫伤感染组,前3 d烫伤感染NPWT组死亡率显著低于烫伤感染换药组(P<0.05)。结论早期使用NPWT,创面细菌含量可以快速降低,减轻全身炎症反应及脏器损伤,降低烧伤创面脓毒症的发病率和死亡率。Objective To observe the effect of negative pressure wound therapy（ NPWT） on the mortality of burn wound sepsis in mice. Methods Ninety healthy male C57 mice were divided into control group and experimental group according to random digits table method. After postinjury infection models were established,the experimental group was treated with NPWT,while the control group received wet to dry（ WTD） therapy with stroke-physiological saline solution. The bacterial fluorescence expressions and changes of organ pathology in the two groups were observed. The other 48 mice were divided into ambustion group（ group A）,ambustion-infected group（ group B）,ambustion-infected group with NPWT（ group C） and ambustion-infected group with change dressings（ group D） according to random digits table method,and 7 d survival analysis was performed in the four groups. Results Expressions of fluorescence intensity of coal maceral in experimental group at 1,3 and 5 d were significantly lower than those in control group（ P ＆lt; 0. 01）,and changes of organ pathology in experimental group were significantly smaller than those in control group. The 7 d survival rate in group C was significantly higher than that in group B,and the mortality during the first 3 days in group C was significantly lower than that in group D（ P ＆lt; 0. 05）. Conclusion The NPWT used in early stage can quickly reduce the bacterial content in the wound,relieve the systemic inflammatory reaction and organ damage,and reduce the mortality and incidence rates of the burn wound sepsis.

关 键 词：烧伤 脓毒症 假单胞菌 铜绿 小鼠 

分 类 号：R644[医药卫生—外科学]