给氧负压伤口治疗改善伤口微环境对组织增殖活性及血管化的影响

Effects of oxygen-enriched negative pressure wound therapy in improving wound microenvironment to tissue proliferation and vascularization

目的给氧负压伤口治疗改善伤口微环境对组织增殖活性和血管化的作用尚不明确。文章探讨给氧负压伤口治疗改善伤口微环境对组织增殖活性及血管化的影响。方法选取2019年1月至10月东部战区总医院门诊伤口护理中心就诊患者64例,并采用完全随机法分为试验组(n=32)和对照组(n=32)。分别采用给氧负压伤口治疗和负压伤口治疗连续干预2周。观察各组患者接受干预前和干预期间伤口温度、酸碱度变化。取伤口处分泌物和伤口床组织做细菌培养和免疫组织化学染色,观察干预前和干预后14 d伤口细菌培养结果、组织增殖活性和微血管密度。干预结束后给予标准湿性治疗并随访至伤口愈合或干预后3个月,观察伤口愈合率及伤口愈合时间。结果连续2周干预后,试验组和对照组患者伤口温度均显著提高,pH值显著降低,干预组效果更优,差异均有统计学意义(P<0.05)。试验组和对照组干预后细菌培养阳性率分别为26.67%和41.38%,差异无统计学意义(P=0.233);与对照组相比,试验组患者组织活性提高和微血管密度增加更显著(P<0.05)。随访至干预后3个月,试验组患者伤口愈合率较对照组提高12.5%,平均伤口愈合时间缩短9.2 d,差异均有统计学意义(P<0.05)。结论给氧负压伤口治疗能够改善伤口微环境,降低伤口处细菌培养阳性率,提高伤口组织增殖活性和血管化程度,有助于促进伤口愈合。

Objective It is indefinited that oxygen-enriched negative pressure wound therapy,namely negative pressure wound therapy combined with topical oxygen therapy(NPWT+TOT),improve the effects of wound microenvironment in tissue proliferation and vascularization.The objective is to discuss effects of oxygen-enriched negative pressure wound therapy in improving wound microenvironment to tissue proliferation and vascularization.Methods To select sixty-four patients in the outpatient wound care center of the eastern theater general hospital from January to October,2019,which were randomly divided into the experimental group(NPWT+TOT)and the control group(NPWT),32 cases in each group.The patients were treated with oxygen-enriched negative pressure wound and negative pressure wound respectively for 2 weeks to observe the changes of wound temperature and PH before and during intervention.Bacterial culture and immunohistochemical staining which were made from wound secreta and wound bed tissues to observe bacterial culture results,tissue proliferation activity and microvascular density before intervention and 14 days after intervention.After the intervention,the patients were treated by standard wet therapy and followed up to wound healing or 3 months after the intervention to observe the wound healing rate and wound healing time.Results After two weeks'continuous intervention,wound temperature of patients increased and PH value decreased significantly between the experimental group and the control group.Meanwhile,the intervention group was more effective,and there were significant differences between the two groups(P<0.05).The positive rate of bacterial culture after intervention in the experimental group and the control group was 26.67% and 41.38% respectively,with no statistically significant difference(P=0.233).Compared with the control group,the increase of tissue activity and microvascular density in the experimental group was more significant(P<0.05).After three months'follow-up,the wound healing rate of the experimental group was increased by 12.5% compared with the control group,and the average wound healing time was shortened by 9.2 days.Conclusion Oxygen-enriched negative pressure wound therapy can improve wound microenvironment,reduce the positive rate of wound bacterial culture,improve the proliferation activity of wound tissue and degree of vascularization,and promote wound healing.