负压疗法的科学原理和运用

Negative Pressure Therapy: Theory and Practice

负压疗法(NPT,negative pressure therapy),也可称为封闭负压引流技术(VAC,vacuum-assisted closure),是用来促进伤口愈合的一种治疗方法。它既可以用于慢性复杂伤口的一期治疗,又可辅助临时关闭伤口及术前创口区的前期准备工作,如植皮术和皮瓣手术。虽然其作用的生理基础尚未得到完全阐释,但其临床效果已经被证明。我们在Pubmed-medline上选择基于随机临床试验、封闭负压引流技术和局部负压的相关研究进行分析。对来源于动物实验,随机临床试验,临床应用观察的科学数据进行评估,并对VAC治疗有影响的病案报道进行分析。系统的数据分析显示,负压疗法在诱导伤口的愈合,特别是在创面早期愈合发挥方面的作用是非常显著的。此外,数据分析表明负压疗法在抗感染治疗方面有积极作用。实验数据证明VAC在促进创口愈合方面是有效的,但是关于其作用机制仍不清楚。因为循证医学数据不能很好的解释临床治疗的良好效果,还需要进一步的随机、盲法研究。尽管如此,我们认为合理的使用负压治疗,特别是经验丰富的外科医生运用,是促进伤口愈合的一个很好的方法。

NPT（negative pressure therapy）which also can be called VAC（vacuum-assisted closure）is a treatment which can promote wound healing.It can not only be used to one stage treatment of chronic and complex wounds but also can assist to temporary close the wound and to the preparatory work of pre-operation wound area such as dermatoplasty. Although the physiological basis of VAC has been not fully expounded, the clinical effects have been proved.We analysed the relevant researches that based on randomized clinical trial, VAC and topical negative pressure which are chosen from Pubmed-medline and assessed the scientific data which derived from animal experiment, randomized clinical trial and observing in clinical application. According to the data, NPT has remarkable effects in inducing wound healing especially in early stage of wound healing. Besides, NPT also has positive effect in anti-infective therapy. Experimental data have presented that VAC has positive effect in promoting wound healing. But the functional mechanism of it has not been clarified because of evidence-based medicine data could not explain the positive effects of clinical treatment. Although there still need further random and blind method to explain its effects, we deem that reasonable using VAC especially using by prectised surgeon is a commendable treatment to promoting wound healing.