摘要
目的使用常规负压伤口治疗技术(negative pressure wound therapy NPWT)和具有保护盘的NPWT测量微血管内血液流速在肠壁和大网膜之间的变化。方法将12头实验用猪行正中切口开腹并应用负压伤口治疗技术,随机分为常规NPWT组6头(传统组)和在小肠和负压源之间放置有保护盘NPWT组6头(保护盘组)。使用激光多普勒测速仪测量两组分别使用负压值为-50、-70、-100、-120、-150和-170mmHg的负压伤口治疗装置下的相关肠襻和大网膜微血管内血液流速。结果传统组动物血管壁的微血管血流速度显著低于保护盘组(P<0.01)。在负压值为-50mmHg的负压伤口治疗中,保护盘组血流灌注大于传统组(2.5±0.1)PU VS(2.0±0.2)PU(P<0.05);在负压值为-170mmHg的负压伤口治疗中,保护盘组的血流灌注大于传统组(3.4±0.3)PU VS(1.5±0.2)PU(P<0.01)。结论传统NPWT中微血管血流量比具有保护盘的NPWT显著降低,且血流量随着负压值的增加而减少。负压伤口治疗术在开放性腹部伤口治疗中是一种非常有效的治疗方法。保护盘具有保护小肠,维持微血管血流量的作用。
Objective The present study measured microvascular blood flow in the intestinal wall using conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source.Methods 12 pigs underwent midline incision and application of NPWT to the open abdomen.The microvascular blood flow in the underlying intestinal loop wall was recorded with conventional NPWT and NPWT with a protective disc between the intestines and the vacuum source of-50,-70,-100,-120,-150,and-170 mmHg respectively,using laser Doppler velocimetry.Results A significant decrease in microvascular blood flow was seen in the intestinal wall during application of all negative pressures levels.The flow was 2.5(±0.1)Perfusion Units(PU)with NPWT with a protective disc and 2.0(±0.2)PU(P〈0.05)with conventional NPWT of-50 mmHg,and 3.4(±0.6)PU with NPWT with a protective disc and 1.5(±0.2)PU(P〈0.01)with conventional NPWT of-170 mmHg.Conclusion In the present study,the microvascular blood flow in the intestinal wall were significantly smaller following conventional NPWT,than using NPWT with a protective disc between the intestines and the vacuum source.The decrease in blood flow inceased with the amount of negative pressure applied.We believe that NPWT of the open abdomen is a very effective treatment but could probaly be improved.
出处
《西部医学》
2015年第7期971-974,共4页
Medical Journal of West China
基金
四川省科技厅科研项目(30504010107
30305030273)
关键词
负压伤口治疗
开放性腹部
微血管内血液流速
小肠壁
Negative pressure wound therapy
Open abdomen
Microvascular blood flow
Intestinal wall