封闭式负压引流技术治疗兔胸部开放性伤口的效果  

Efficacy of vacuum sealing drainage in treatment of open wound infection in the chest of rabbits

作　　者：王康[1] 秦涛[1] 吴海卫[1] 钱建军[1] 李德闽[1] 

机构地区：[1]南京大学医学院附属金陵医院心胸外科,南京210001

出　　处：《山西医科大学学报》2017年第2期132-135,共4页Journal of Shanxi Medical University

基　　金：南京总医院课题(2014033)

摘　　要：目的观察封闭式引流技术治疗胸壁开放性创口感染的效果。方法取30只SPF成年新西兰白兔随机分为5组,给予氯胺酮耳静脉注射麻醉,选取第6肋间距脊柱7 cm处切开皮肤至肋骨,创口为2 cm×2 cm。以金黄色葡萄球菌液0.9 ml于胸壁伤口处慢慢滴入,再涂擦,2次/d,至感染成功,剪开胸膜放置VSD负压材料,每隔6 h检查装置密闭性,分别给予0,10,16.6,30,46.5 kPa的负压引流。每天观察创口愈合情况并在术后第1,3,5天评估胸壁伤口液体引流量,胸膜愈合时间,肉芽组织填充率以及肺损伤评分等指标的组间差别。结果随着VSD置入,10-46.5 kPa组第3,5天引流量与第1天比较显著增多(P<0.05);16.6-46.5 kPa组与0 kPa组及10 kPa组分别比较,均显著增多(P<0.05)。胸膜愈合时间30,46.5 kPa组与0 kPa组比较胸膜愈合快(P<0.05)。VSD安置第7天创口肉芽组织填充率,16.6,30 kPa组显著超过0,10,46.5 kPa组(P<0.05);10,46.5 kPa组充填率显著超过0 kPa组(P<0.05),10-46.5 kPa组均有肉芽组织增生,新生毛细血管明显。0 kPa,46.5 kPa组感染创口侧肺组织活检可见轻度肺泡和毛细血管损伤并有间质渗出,肺损伤评分分别为(3.10±0.88)分和(2.90±1.00)分,其余各组未见明显肺损伤表现。结论对兔胸部开放性创口感染采用16.6-30 kPa负压引流技术可取得较好的治疗效果。Objective To study the efficacy of vacuum sealing drainage in treatment of open wound infection in the chest of rabbit. Methods Thirty rabbits with open wound infection in the chest were divided into 0,10,16. 6,30,46. 5 kPa groups according to the dif- ferent subpressure. All the defects were connected to the disposable VSD devices. Gas was pumped out of pleural cavity by VSD with the help of vacuum gauge. The drainage fluid, healing time, filling rate of granulation tissue, lung injury score and wound healing were observed and compared at 1,3,5 day after operation. Results The daily drainage fluid volume was significantly higher at 3,5 day than at 1 day in 10, 16.6, 30, 46.5 kPa groups（P 〈0.05）, and the fluid volume was significantly higher in 16.6 -46.5 groups than in 0 kPa group and 10 kPa group（P 〈0.05）. The healing time was significantly shorter in 30,46.5 kPa groups than in 0 kPa group（P 〈 0.05 ）. The filling rate of granulation tissue in 16.6 kPa and 30 kPa groups were higher than that in the other groups（ P 〈 0.05 ）, and the rate was also higher in 10,46.5 kPa group than in 0 kPa group （P 〈 0.05）. The lung injury scores in 0 kPa group and 46.5 kPa group were 3.10 ± 0.88 and 2.90 ± 1.00, respectively, and there was no lung injury in the other groups. Conclusion VSD with 16.6 - 30 kPa pressure is a compromising method in treatment of open wound infection in the chest of rabbit, which is worthy of the promotion.

关 键 词：封闭式负压引流 开放性创口 感染治疗 

分 类 号：R655[医药卫生—外科学]