负压封闭引流联合局部氧疗对慢性难愈性创面微环境和缺氧状态的影响  

Effects of vacuum sealing drainage combined with local oxygen therapy on microenvironment and hypoxia status of chronic refractory wound

作　　者：杜荣艳 郑苗苗 沈泽坤 Du Rongyan;Zheng Miaomiao;Shen Zekun(Department of General Surgery,The 7th People’s Hospital of Zhengzhou,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第七人民医院普外科,河南郑州450000

出　　处：《感染、炎症、修复》2024年第2期92-95,共4页Infection Inflammation Repair

摘　　要：目的:探讨负压封闭引流(VSD)联合局部氧疗对难愈性创面肉芽组织生长、创面微环境及缺氧状态的影响。方法:选择2018年6月至2022年6月郑州市第七人民医院收治的难愈性创面患者206例,随机分为对照组(103例,予传统清创联合换药方式治疗)和观察组(103例,予VSD联合局部氧疗治疗)。观察两组创面愈合情况,比较治疗前和治疗后21 d创面温度、创面渗液酸碱度(pH试纸测定)、血C反应蛋白(CRP)水平、组织琥珀酸脱氢酶和乳酸脱氢酶水平。结果:观察组换药次数少于对照组(P<0.001),肉芽组织生长面积及创面愈合率高于对照组(P<0.001),完全愈合、住院时间较对照组短(P<0.001)。治疗后21 d观察组伤口温度、渗液酸碱度、CRP水平低于对照组(P<0.001),创面组织琥珀酸脱氢酶水平高于对照组、乳酸脱氢酶水平低于对照组(P<0.001)。结论:VSD联合局部氧疗可以改善难愈性创面患者的创面微环境及缺氧状态,促进创面愈合,减少换药次数,缩短住院时间。Objective:To investigate the effects of vacuum sealing drainage(VSD)combined with local oxygen therapy on refractory wound granulation tissue growth,wound microenvironment and hypoxia status.Methods:A total of 206 patients with refractory wounds admitted to the 7th People’s Hospital of Zhengzhou from June 2018 to June 2022 were randomly divided into the control group(n=103,treated with traditional debridement combined with dressing change)and the observation group(n=103,treated with VSD combined with local oxygen therapy).The wound healing of the two groups was observed,and the wound temperature,the pH of wound exudate(measured by pH test paper),the level of blood C-reactive protein(CRP),the level of tissue succinate dehydrogenase and lactate dehydrogenase were compared before treatment and 21 days after treatment.Results:The observation group had fewer dressing changes than the control group(P<0.001),and the growth area of granulation tissue and wound healing rate were higher than the control group(P<0.001).The complete healing and hospital stay were shorter than the control group(P<0.001).Twenty-one days after treatment,the wound temperature,exudate pH,CRP level in the observation group were lower than those in the control group(P<0.001),the succinate dehydrogenase level in the wound tissue was higher than that in the control group,and the lactate dehydrogenase level was lower than that in the control group(P<0.001).Conclusions:VSD combined with local oxygen therapy can improve the wound microenvironment and hypoxia status of patients with refractory wounds,promote wound healing,reduce dressing changes and shorten hospital stay.

关 键 词：创面 难愈性 负压封闭引流 氧疗 局部 微环境 缺氧 

分 类 号：R641[医药卫生—外科学]