局部氧疗联合重组牛碱性成纤维细胞生长因子合并负压引流技术应用在慢性难愈性创面的疗效  

Efficacy of local oxygen therapy combined with rb⁃bFGF and negative pressure drainage technology in chronic refractory wounds

作　　者：白子烨 王怀谷[1] 张莉[1] 朱坤[1] 崔雷 韩娜 王硕 BAI Ziye;WANG Huaigu;ZHANG Li;ZHU Kun;CUI Lei;HAN Na;WANG Shuo(Department of Plastic Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院整形外科,安徽蚌埠233004

出　　处：《实用医学杂志》2022年第20期2561-2567,共7页The Journal of Practical Medicine

基　　金：安徽省教育厅自然科学重点项目(编号:KJ2021A0743)。

摘　　要：目的分析局部氧疗联合重组牛碱性成纤维细胞生长因子(rb⁃bFGF)合并负压引流技术(VSD)在慢性难愈性创面的作用。方法选取2020年10月至2021年10月蚌埠医学院第一附属医院整形烧伤科收治的40例慢性难愈性创面患者,随机分为对照组和观察组。对照组清创扩创后予以封闭式负压引流(VSD)联合生理盐水治疗,观察组在对照组的基础上采用创面局部氧疗并联合rb⁃bFGF溶液灌洗治疗。对比两组患者住院时间及费用、临床疗效、NRS疼痛评分,取术前、术后7 d创面组织HE染色观察组织病理学变化情况(创面炎性细胞变化),取术前、术后7、14 d创面组织进行免疫组化染色检测VEGF及HIF⁃1α表达情况。结果与对照组相比,观察组住院时间明显缩短,住院费用减少较明显,疼痛减轻也较明显,差异有统计学意义(P<0.05);与对照组相比,观察组治疗总有效率较高,差异有统计学意义(P<0.05);与对照组相比,观察组创面组织HE染色炎性细胞明显减少,差异有统计学意义(P<0.05);与对照组相比,观察组创面组织VEGF及HIF⁃1α免疫组化染色提示,VEGF表达量明显增高,HIF⁃1α表达量减少,差异均有统计学意义(P<0.05)。结论(1)局部氧疗联合rb⁃bFGF合并VSD治疗,治疗效果明显优于VSD联合生理盐水冲洗治疗;(2)局部氧疗联合rb⁃bFGF合并VSD治疗,可明显改善创面状态,降低HIF⁃1α表达量,提高VEGF表达量,改善创面微循环,加速创面愈合,缩短患者住院时间,减轻患者经济负担。Objective To analyze the effect of local oxygen therapy combined with recombinant bovine basic fibroblast growth factor(rb⁃bFGF)and negative pressure drainage(VSD)on chronic refractory wounds.Methods From October 2020 to October 2021,40 patients with chronic refractory wounds who were admitted to the Department of Plastic and Burn Surgery,The First Affiliated Hospital of Bengbu Medical College,were selected and randomly divided into control group and experimental group.The control group was treated with debridement and then with closed negative pressure drainage(VSD)combined with normal saline,while the experimental group was treated with local oxygen therapy combined with rb⁃bFGF lavage on the basis of the control group.The hospital⁃ization time and cost,clinical efficacy,and NRS pain score were compared between the two groups,and the wound tissues were collected before operation,7 days after the operation to observe the histopathological changes(the number of inflammatory cells in the wound),and immunohistochemical staining of VEGF and HIF⁃1αexpres⁃sion.Results Compared with the control group,the experimental group had significantly shorter hospitalization time,lower hospitalization expenses,and less pain,and the differences were statistically significant(P<0.05).Compared with that in the control group,the number of inflammatory cells in the wound tissue of the experimental group was significantly reduced,showing statistical significance(P<0.05).The immunohistochemical staining of VEGF and HIF⁃1αin the wound tissue in the experimental group showed that the expression of VEGF was signifi⁃cantly increased,but that of HIF⁃1αwas decreased,and the differences were statistically significant(P<0.05).Conclusion The therapeutic effect of local oxygen therapy combined with rb⁃bFGF and VSD is significantly better than that of VSD combined with saline irrigation. Local oxygen therapy combined with rb⁃bFGF and VSD can signif⁃icantly reduce HIF⁃1α,increase the expression of VEGF,and improve the mi

关 键 词：局部氧疗 负压引流技术 重组牛碱性成纤维细胞生长因子 慢性难愈性创面 

分 类 号：R622[医药卫生—整形外科]