摘要
目的探讨自制血管保护套联合负压封闭引流(VAC)治疗兔下肢血管裸露创面的有效性。方法清洁级新西兰兔24只,采用随机数字表法分为模型组、VAC组、联合治疗组,每组8只。切除右大腿内侧3 cm×4 cm皮肤和部分筋膜,构建血管裸露创面模型。模型组常规包扎换药治疗,VAC组予-120 mmHg压力吸引治疗,联合治疗组予自制血管保护套覆盖血管后以-120 mmHg压力吸引治疗,于治疗后第7、14天比较各组创面大体情况、镜下血管形态、创面愈合率以及新生血管相关基因表达情况。结果治疗后第14天联合治疗组创面肉芽生长及血管受压情况优于VAC组和模型组。治疗后第7、14天联合治疗组创面愈合率均高于VAC组和模型组,创面组织新生血管血管内皮生长因子、血小板衍生生长因子、血小板内皮细胞黏附分子1、酪氨酸激酶受体Eph亚族的配体表达水平均高于VAC组和模型组,差异均有统计学意义(均P<0.05)。结论自制血管保护套联合VAC治疗可有效避免裸露血管受压,并可通过改善局部血供加速创面愈合。
Objective To study the efficacy of self-made vascular protective sheath combined with vacuum-assisted closure(VAC)in treatment of vascular exposed wounds in rabbits.Methods Using random number table method,twenty-four New Zealand rabbits were divided into three groups:model group,VAC group and combined treatment group.A 3 cm×4 cm skin and partial fascia of the right thigh of rabbit were excised to construct the vascular exposed wound model.Wounds in model group received routine dressing therapy,wounds in VAC group received-120 mmHg pressure suction,and wounds in combined treatment group received-120 mmHg pressure suction after covering the exposed vessels with protective sheaths.General condition and healing rate of wounds,morphology of blood vessels,expression of neovascularization related genes were compared among three groups 3 and 7 days after modeling.Results After 14 days of treatment,the combined treatment group had less vascular compression and more granulation growth,compared with the model group and the VAC group.Meanwhile,the healing rate of combined treatment group was significantly higher than that of VAC group and model group(both P<0.05).In the combined treatment group,the expression of vascular endothelial growth factor(VEGF),platelet derived growth factor(PDGF),platelet endothelial cell adhesion molecule 1(PECAM-1/CD31)and ephrin B2 was significantly up-regulated,compared to VAC group and the model group(all P<0.05).Conclusion Vascular protective sheath combined with VCA can effectively avoid the pressure of exposed vessels and accelerate wound healing by improving local blood supply.
作者
周化腾
胡文跃
杜伟斌
胡华辉
蔡兵兵
王利祥
ZHOU Huateng;HU Wenyue;DU Weibin;HU Huahui;CAI Bingbing;WANG Lixiang(Department of Orthopedics,Affiliated Jiangnan Hospital of Zhejiang Chinese Medical University,Hangzhou 311201,China)
出处
《浙江医学》
CAS
2020年第22期2408-2411,共4页
Zhejiang Medical Journal
基金
杭州市科技计划引导项目(20171226Y93)
杭州市卫生计生科技计划项目(2018B030)
杭州市萧山区重大科技攻关项目(2017208)。
关键词
负压封闭引流
血管保护套
裸露血管
创面修复
Vacuum-assisted closure
Vascular protective sheath
Exposed blood vessels
Wound repair
