不同暂时性关腹材料对腹腔开放后创面愈合影响的研究

Study on the effect of different temporary abdominal closed materials to wound healing after open abdomen

目的观察腹腔开放后腹腔创面愈合的基本过程以及观察不同暂时性关腹材料对于愈合过程的影响。方法选择24只健康SD雌性大鼠,随机分成四组:A组,单纯聚乙烯片临时关腹;B组,单纯聚丙烯网片临时关腹;C组,聚丙烯网片临时关腹外用生长激素;D组,聚丙烯网片临时关腹外用成纤维细胞生长因子。于腹腔开放后7d取创面肉芽,作病理组织学观察、肉芽微血管密度(MVD)计数、肉芽组织厚度及肉芽成纤维细胞数目比较。结果各组创面愈合均良好,但聚丙烯网片关腹外用成纤维细胞生长因子组创面肉芽厚度、肉芽内微血管密度(MVP)及成纤维细胞数目都优于其他三组(P值均<0.05)。结论聚丙烯网片应用于腹腔开放病人,可促进开放处肉芽组织的生长。局部加用生长激素和碱性成纤维细胞生长因子,可进一步加速创面的愈合,其中以聚丙烯网片外用成纤维细胞生长因子效果最好。

Objective To observe the basic procedure of wound healing after open abdomen and observe the effect of different temporary abdominal closed materials on wound healing. Method Rats were divided into four groups each have 6 animals. After 24h of induction of peritonitis and abdominal compartment syndrome, relaparotomies were done, and the abdomen was closed by different temporary abdominal closure techniques： group A, by 3-L sterile plastic bag; group B, by Polypropylene mesh; group C, by Polypropylene mesh plus GH; group D, by Polypropylene mesh plus bFGF. On 7th day after open abdomen, the granulation tissue was assessed pathologically, and to measure MVD, the thickness of granulation tissue and the count of fibroblast. Results MVD, the thickness of granulation tissue and the count of fibroblast were higher in Polypropylene mesh closure plus bFGF rats than other groups. （P〈0.05） Conclusion Polypropylene can promote the wound healing of open abdomen. Local application GH and bFGF can more hasten growing of granulation tissue, and the effect of local application bFGF is the best.