负压创面技术在颈淋巴结核外科治疗中的应用  

Use of negative pressure wound therapy in surgical treatment of cervical lymphatic tuberculosis

作　　者：江涛[1] 薛丽京[1] 连贵勇[1] 周薇 薛宗锡[1] 肖泽林[1] 曾定科 高健齐[1] Jiang Tao;Xue Lijing;Lian Guiyong;Zhou Wei;Xue Zongxi;Xiao Zelin;Zeng Dingke;Gao Jianqi(First Division,Department of Surgery,Guangzhou Chest Hospital,Guangzhou,Guangdong 510095,China)

机构地区：[1]广州市胸科医院外一科,广东广州510095

出　　处：《广州医科大学学报》2020年第4期33-37,共5页Academic Journal of Guangzhou Medical University

基　　金：广东省医学科学技术研究基金项目(A2019290);广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]1555号);广东省转化医学创新平台培育建设项目B类(粤卫函[2018]1254号)。

摘　　要：目的:探讨负压创面技术对颈淋巴结核术后创面愈合的疗效。方法:选择2019年4月至2020年1月广州市胸科医院外科收治的80例颈淋巴结核患者作为研究对象,随机分为研究组和对照组,每组各40例。两组均以常规手术方式行淋巴结核病灶清除术或区域性颈淋巴结清扫,研究组术后创面采用负压创面技术;对照组常规放置纱块引流,清洁换药治疗。比较两组创口边缘VEGF和CD34的变化,比较两组手术时间、术后换药次数、伤口愈合时间、术后住院时间等指标。结果:术后7 d,两组创缘标本VEGF阳性表达均有增加,CD34显示微血管计数增加,其中研究组较对照组增加更明显(P<0.05);研究组术后换药次数和伤口愈合时间少于对照组(P<0.01),手术时间和术后住院时间高于对照组(P<0.01)。结论:负压创面技术使颈淋巴结核外科术后创面VEGF、CD34表达增强,可减少术后换药次数,加速伤口愈合,但会增加手术和术后住院时间。Objective:To investigate the efficacy of negative pressure wound therapy on wound healing after surgery for cervical lymphatic tuberculosis.Methods:Eighty patients with cervical lymphatic tuberculosis admitted to the Department of Surgery,Guangzhou Chest Hospital between March 2019 and January 2020 were included as the subjects in the study.All patients were randomly divided into the study group and control group(n=40 each).Both groups underwent conventional lymphadenectomy or regional neck lymph node dissection.The study group was treated with negative pressure wound therapy after the operation.The control group received routine gauze drainage with wound cleansing and dressing.The changes in VEGF and CD34 expression in the wound margin,the operation time,postoperative times of wound dressing,time to wound healing and postoperative length of hospital stay were compared between the two groups.Results:The positive expression level of VEGF in wound margin specimens of the two groups increased at 7d after the operation,and CD34 immunohistochemistry showed increased microvascular count.However,the increase in the study group was more obvious than that in the control group(P<0.05).The times of wound dressing and time to wound healing in the study group were significantly less than those in the control group(both P<0.01).The operation time and postoperative length of hospital stay in the study group were longer than those in the control group(both P<0.01).Conclusion:Negative pressure wound therapy after surgery for cervical lymphatic tuberculosis may significantly enhance the expression of VEGF and CD34 in wound surface,reduce the times of postoperative dressing,and accelerate wound healing,but with longer operation time and postoperative length of hospital stay.

关 键 词：颈淋巴结 结核 负压 愈合 生长因子 

分 类 号：R522[医药卫生—内科学]