高压氧联合VSD治疗对皮瓣修复腕背部复合组织缺损及血清炎性因子水平的影响  

Effect of hyperbaric oxygen combined with VSD on the repair of wrist dorsal complex tissue defect with skin flap and the level of serum inflammatory factors

作　　者：王志龙[1] 吕岩丽 季远[3] 李英 杜俊宏 辛大江[5] Wang Zhilong;Lyu Yanli;Ji Yuan;Li Ying;Du Junhong;Xin Dajiang(Department of Hand Surgery(Ⅰ),Yantai Mountain Hospital,Yantai 264001,China;Department of Emergency,Yantai Zhifu Hospital,Yantai 264001,China;Department of Hand Surgery(Ⅱ),Yantai Mountain Hospital,Yantai 264001,China;Department of Orthopedics(Ⅱ),Yantai Harbor Hospital,Yantai 264001,China;Department of Traumatic Orthopedics,Yantai Mountain Hospital,Yantai 264001,China)

机构地区：[1]烟台市烟台山医院手外一科,烟台264001 [2]烟台市芝罘医院急诊科,烟台264001 [3]烟台市烟台山医院手外二科,烟台264001 [4]烟台海港医院骨二科,烟台264001 [5]烟台市烟台山医院创伤骨科,烟台264001

出　　处：《中华航海医学与高气压医学杂志》2022年第6期836-839,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的:探讨高压氧联合负压封闭引流(VSD)对皮瓣修复腕背部复合组织缺损及血清炎性因子水平的影响。方法:选取2016年3月至2019年3月烟台市烟台山医院收治的92例腕背部复合组织缺损患者,依照随机数字表法分为对照组和联合组,每组46例。对照组采用VSD技术进行皮瓣修复,联合组采用高压氧联合VSD技术进行皮瓣修复,比较2组患者的住院时间、创面愈合时间、临床疗效、血清炎性因子水平以及并发症发生情况。结果:联合组患者住院时间和创面愈合时间均短于对照组(P<0.01);治疗1个月后2组患者疗效等级分布比较差异有统计学意义(P<0.05),且联合组优良率明显高于对照组(P<0.05);治疗1个月后,2组患者的血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)水平均降低(P<0.05),且联合组低于对照组(P<0.01);联合组患者并发症发生率低于对照组(P<0.05)。结论:高压氧联合VSD用于腕背部复合组织缺损创面修复能够缩短皮瓣修复时间,降低炎性因子水平,降低并发症发生率。Objective:To explore the effect of hyperbaric oxygen combined with vacuum sealing drainage(VSD)on the repair of wrist dorsal complex tissue defect with skin flap and the level of serum inflammatory factors.Methods:Ninety-two cases with wrist dorsal complex tissue defect who were admitted to Yantai Mountain Hospital from March 2016 to March 2019 were divided into control group and combined group according to the random number table method,with 46 cases in each group.The control group used VSD for skin flap repair,while the combined group used hyperbaric oxygen combined with VSD for skin flap repair.The length of stay,wound healing time,clinical efficacy,serum inflammatory factor levels,and the occurrences of complications of the two groups were compared.Results:The length of stay and wound healing time of the combined group were shorter than those of the control group(P<0.01).After one month of treatment,there were significant differences in the grade distribution of curative effect between the two groups(P<0.05),and the rate of excellent and good efficacy in the combined group was higher than that in the control group(P<0.05).After one month of treatment,the levels of serum inflammatory factors,i.e.,interleukin-6(IL-6),interleukin-8(IL-8),and tumor necrosis factor alpha(TNF-α),in the two groups decreased(P<0.05),and the levels of the combined group were lower than those of the control group(P<0.01).The incidence of complications in the combined group was lower than that in the control group(P<0.05).Conclusion:The use of hyperbaric oxygen combined with VSD for the wound repair of wrist dorsal complex tissue defect can shorten the time of skin flap repair,reduce the levels of inflammatory factors,and reduce the incidence of complications.

关 键 词：高压氧 负压封闭引流 皮瓣 复合组织缺损 创面修复 血清炎性因子 

分 类 号：R622[医药卫生—整形外科]