摘要
目的观察高氧液冲洗联合负压封闭引流技术治疗慢性创面过程中局部微循环的变化情况。方法将慢性创面患者80例随机分为对照组和试验组,各40例。对照组患者采用负压封闭引流+生理盐水冲洗技术,试验组患者在对照组治疗基础上加用高氧液冲洗。治疗7 d后,分别留取两组患者创面中心肉芽组织做HE染色和CD31免疫组化染色,在显微镜下比较:①创面新生毛细血管生长情况,周围纤维母细胞分布;②组织CD31表达及微血管密度。结果①肉芽组织HE染色观察:40倍镜下,试验组创面肉芽组织内纤维母细胞增生明显且排列规则,有较多胶原纤维生成,可见较多新生毛细血管;对照组纤维母细胞增生不明显,排列稀疏且不规整,胶原纤维少,新生毛细血管也较少。②CD31免疫组化表达及微血管密度观察:两组创面组织都有CD31表达,但试验组比对照组表达丰富,明显优于对照组;100倍镜下,试验组微血管密度明显高于对照组(t=-704.38,P<0.05)。结论高氧液冲洗联合负压封闭引流冲洗技术应用于慢性创面治疗,能促进纤维母细胞增生,使胶原纤维生成增多,加快新生毛细血管生长,有效改善创面微循环,加速创面修复。
Objective To observe the changes of microcirculation in chronic wound treated with hyperoxia solution washing combined with vacuum sealing drainage. Methods Eighty cases of patients with chronic wound were randomly divided into control group and experimental group, with 40 cases in each group. The control group was treated with vacuum sealing drainage and saline flush, while the experimental group added hyperoxia solution washing on the basis of the control group.After treated for 7 days, the granulation tissue from wound center were collected for HE and CD31 immunohistochemical staining, under the microscope were observed and compared：①the growth of the newborn capillaries and the distribution of the surrounding fibroblasts;②the expression of CD31 and microvessel density. Results①HE staining observation of granulation tissue： under the microscope with 40 magnification, the fibroblast proliferated markedly and arranged regularly with more collagen fiber and capillaries in granulation tissue in the experimental group; while in the control group, the fibroblast proliferated poorly and arranged sparsely and irregularly with less collagen fibers and capillaries.②Immuno histochemical expression of CD31 and microvessel density： both group had the expression of CD31, but that in the experimental group was significantly more plentiful than the control group; under the microscope with 100 magnification, the microvessel density of the experimental group was higher than that of the control group（t=-704.38, P〈0.05）. Conclusion Hyperoxia solution washing combined with vacuum sealing drainage in the treatment of chronic wound can promote fibroblast proliferation,collagen fiber formation and new capillary growth, effectively improve microcirculation and accelerate wound healing.
出处
《临床医学研究与实践》
2017年第17期7-8,15,共3页
Clinical Research and Practice
关键词
慢性创面
高氧液冲洗
负压封闭引流
微循环
chronic wound
hyperoxia solution washing
vacuum sealing drainage
microcirculation
