VSD对高位肛周脓肿临床效果及aFGF、bFGF表达的影响  

Effect of VSD on clinical effect of high perianal abscess and expression of aFGF and bFGF

作　　者：王传思 谢贻祥 姚磊 黄鸿武 张琦[2] 王小龙 任龙 王永森 杨松 Wang Chuansi;Xie Yixiang;Yao Lei;Huang Hongwu;Zhang Qi;Wang Xiaolong;Ren Long;Wang Yongsen;Yang Song(Department of Colorectal Surgery,the Affiliated Lu'an Hospital of Anhui Medical University,Lu’an 237005,China)

机构地区：[1]安徽医科大学附属六安医院肛肠外科,六安237005 [2]安徽中医药大学第一附属医院普外科,合肥230031

出　　处：《河南外科学杂志》2018年第6期17-20,共4页Henan Journal of Surgery

基　　金：安徽省卫生和计划生育委员会科研计划项目(全科医学临床科研课题)(2016QK056);国家自然科学基金(81403406);安徽省卫生计生委中医药科研课题项目(2014zy53)

摘　　要：目的观察负压封闭引流(vacuumsealingdrainage,VSD)技术在高位肛周脓肿治疗中的临床效果及对成纤维细胞生长因子(aFGF、bFGF)表达的影响。方法对40例高位肛周脓肿患者根据随机数字表法分为2组,每组20例。研究组行肛周脓肿内口封闭+VSD技术,对照组行肛周脓肿传统低位切开高位挂线术。术后对2组患者的疼痛、肛门功能、愈合时间加以比较,检测不同时间段血清中aFGF、bFGF的含量变化及其磷酸化水平。结果研究组术后疼痛评分、肛门功能评分及创面愈合时间均优于对照组,差异有统计学意义(P<0.05)。2组术前1天血清中的aFGF、bFGF灰度值比值未见明显表达,术后第1天表达均不明显;2组差异无统计学意义(P>0.05)。2组术后第7天均明显上升,与术后第1天比较差异有统计学意义(P<0.05)。术后第7天2组比较,差异具有统计学意义(P<0.05)。结论将VSD技术应用于高位肛周脓肿患者,可使患者疼痛减轻,愈合时间缩短,肛门功能得到有效保护。通过促进aFGF、bFGF表达,从而调控创面血管生成,显著促进创面愈合。Objective To observe the clinical effect of vacuum sealing drainage(VSD)in the treatment of high perianal abscess and its effect on the expression of fibroblast growth factor(aFGF、bFGF). Methods Totally40patients with high perianal abscess were randomly divided into2groups,20cases in each group.The study group underwent perianal abscess closed+VSD technology,while the control group underwent perianal abscess,traditional low incision and high thread drawing operation.After the operation,the2groups were compared from the patients'pain,anus function and healing time,and the changes of aFGF and bFGF levels in the serum and the level of phosphorylation in the serum of different time periods were detected. Results The postoperative pain score,the anal function score and the wound healing time were statistically significant(P<0.05).The VSD technique could reduce the pain of the patients,protect the anal function and shorten the healing time.The ratio of aFGF and bFGF in serum showed that there was no obvious expression of preoperative1d in the two groups,and the expression of postoperative1d was not obvious.There was no significant difference between the two groups(P>0.05).The difference between the study group and the control group increased obviously postoperative7d,and the difference between the group and the postoperative1d had significant meaning(P<0.05).There was a significant difference in postoperative7d between the two groups(P<0.05). Conclusion The application of VSD technology in patients with high anal abscess can make pain relief and healing time shorten,and the anal function is effectively protected.By promoting the expression of aFGF and bFGF,we can regulate wound angiogenesis and promote wound healing.

关 键 词：负压封闭引流 高位肛周脓肿 内口封闭 低位切开高位挂线 酸性成纤维细胞生长因子 碱性成纤维细胞生长因子 

分 类 号：R574.8[医药卫生—消化系统]