封闭负压引流技术对毁损创面恢复血管生成及创周组织血管通透性的影响

Effect of Vacuum-assisted Closure on the Recovery of Angiogenesis of the Damaged Wound Sur- face and Vascular Permeability of Tissues Around the Wound

【目的】探讨封闭负压引流技术对毁损创面恢复血管新生及创周组织血管通透性的保护作用及机制。【方法】收集本院收治的58例皮肤软组织受损的患者，根据入院时间分为治疗组（30例）与对照组（28例）。治疗组患者采用封闭负压引流，对照组采用常规换药治疗，检测并比较两组治疗前1d及治疗后d3、d5、d7创面组织血小板转化因子（PDGF）、转化生长因子β（TGF-β）及血管内皮生长因子（VEDF）的表达水平。【结果】两组治疗前1dPDGF和TGF-β水平比较差异无统计学意义（P〉0．05），治疗d3、d5、d7治疗组PDGF、TGF-β水平显著高于对照组，差异有统计学意义（P〈0．05）；两组前一天及治疗后d3 VEDF水平比较差异无统计学意义（P〉0．05），治疗d5、d7治疗组VEDF水平显著低于对照组（P〈0．05）。【结论】封闭式负压引流技术可促进血管的新生，改善局部微循环，促进组织水肿消退，刺激肉芽组织的新生，加速创面的愈合。

[Objective] To explore the protective effect of vacuum-assisted closure on the recovery of angiogenesis of the damaged wound surface and vascular permeability of tissues around the wound and its mechanism. [Methods] A total of 58 patients with skin and soft tissue damage admitted in our hospital were collected. According to the admission time, all patients were divided into treatment group（ n =30） and control group （ n ~28）. The treatment group received vacuum-assisted closure, while the control group was given conventional dressing treatment. Platelet-derived growth factor（PDGF）, transforming growth factor β（TGF-β） and tional dressing treatment. Platelet-derived growth factor（PDGF）, transforming growth factor β（TGF-β） and vascular endothelial growth factor（VEGF） in wound tissues of two groups at d1 before the treatment, d3, d5 and d7 after treatment were measured and compared. [Results]There was no significant difference in PDGF and TGF-β levels at dl before treatment between two groups（ P 〉0.05）. PDGF and TGF-β levels in treatment group at d3 , ds and dr after treatment were markedly higher than those in control group, and there were significant differences（ P〈0. 05）. There was no significant difference in VEGF level at dl before treatment and d3 after treatment between two groups（ P 〉0.05）, VEGF level in treatment group at d5 and d7 after treatment was significantly lower than that in control group（ P 〈0.05）. [Conclusion]Vacuum-assisted closure can promote angiogenesis, reduce the harmful effect of vascular endothelial, increase the protective effect of the damaged vessel, improve local microcirculation, enhance the regression of tissue edema, stimulate the regeneration of granulation tissue and accelerate wound healing.