负压封闭引流对高位肛周脓肿临床效果及血管内皮细胞生长因子、血小板衍化内皮细胞生长因子表达的影响

Effect of vacuum sealing drainage on the clinical effect of high perianal abscess and the expression of vascular endothelial growth factor and platelet-derived endothelial cell growth factor

目的观察负压封闭引流(VSD)技术在高位肛周脓肿治疗中的临床效果及血管内皮细胞生长因子(VEGF)、血小板衍化内皮细胞生长因子(PD-ECGF)表达的影响。方法对40例高位肛周脓肿患者根据随机数字表法分为两组,每组20例。研究组行肛周脓肿内口封闭+VSD技术,对照组行肛周脓肿传统低位切开高位挂线术。术后从患者的疼痛、肛门功能、愈合及住院时间、治疗费用及复发率等方面对两组患者加以比较,并检测不同时间段血清中VEGF、PD-ECGF的含量变化。结果疼痛及肛门功能评分、创面愈合及住院时间、治疗费用、复发率研究组和对照组比较差异均有统计学意义(P<0.05)。血清中VEGF结果显示,术前1 d研究组(0.134±0.019)和对照组(0.149±0.017),术后1 d研究组(0.272±0.024)和对照组(0.216±0.028)表达均不明显,比较差异均无统计学意义(P>0.05),术后第7天研究组(0.621±0.025)和对照组(0.453±0.038)均明显上升,与术后1 d比较差异有统计学意义(P<0.05)。术后7 d两组比较,差异有统计学意义(P<0.05)。血清中PD-ECGF比值显示,术前1 d研究组(0.125±0.009)和对照组(0.164±0.005),术后1 d研究组(0.233±0.006)和对照组(0.265±0.014)表达均不明显,比较差异均无统计学意义(P>0.05),术后第7天研究组(0.678±0.029)和对照组(0.493±0.016)均明显上升,与术后1 d比较差异有统计学意义(P<0.05)。术后7 d两组比较,差异有统计学意义(P<0.05)。结论将VSD技术应用于高位肛周脓肿患者,可使患者疼痛减轻,愈合及住院时间缩短,节省费用、降低复发率,肛门功能得到有效保护,通过促进VEGF、PD-ECGF表达,从而调控创面血管生成,促进创面愈合。

Objective To observe the clinical effect of vacuum sealing drainage (VSD) in the treatment of high perianal abscess and its effect on the expression of vascular endothelial growth factor (VEGF) and PD-ECGF. Methods 40 cases of high perianal abscess were divided into 2 groups according to the random digital table method, with 20 cases in each group. In the study group,+ VSD was closed to the internal and mouth closure of perianal abscess, and the control group was performed the traditional low position incision of the perianal abscess. Postoperative pain,, anal function, healing time, hospitalization time, treatment cost and recurrence rate were compared between the 2 groups. Serum levels of VEGF and PD-ECGF and their phosphorylation levels were detected at different time points. Results There were significant differences in pain and anal function score, wound healing and hospitalization time, treatment cost, recurrence rate between the study group and the control group (P<0.05). The results of expression VEGF in the serum showed that there was not significant difference between the study group (0.134±0.019) and the control group (0.149±0.017) on preoperative 1 d, the study group (0.272±0.024) and the control group (0.216±0.028) on postoperative 1 d (P>0.05). The postoperative 7 d study group (0.62±0.025) and the control group (0.45±0.038) all increased significantly, which was statistically significant compared with the postoperative 1 d (P<0.05). The difference was statistically significant between the two groups postoperative 7 d (P<0.05). The results of expression PD-ECGF in the serum showed that there was not statistically significant between the study group (0.125±0.009) and the control group (0.164±0.005) on preoperative 1 d, the study group (0.233±0.006) and the control group (0.265±0.014) on postoperative 1 d (P>0.05). The postoperative 7 d study group (0.67±0.029) and the control group (0.49±0.016) all increased significantly, which was statistically significant compared with the postoperative 1 d (P<0.05). The difference was statistically significant between the two groups postoperative 7 d (P<0.05). Conclusion The application of VSD technology in patients with high anal abscess can make pain relief and heal and shorten hospitalization time, save cost and reduce relapse rate, and the anal function is effectively protected. By promoting the expression of VEGF and PD-ECGF, we can regulate wound angiogenesis and promote wound healing.