负压封闭引流术对Ⅲ、Ⅳ期压疮感染创面血管神经生成的影响

Effect of vacuum sealing drainage on blood vessel and nerve formation in wounds of stage Ⅲ and Ⅳ pressure ulcer

目的:探讨负压封闭引流术对压疮感染创面血管和神经生成的影响。方法:选择我院2018年1月至2019年12月治疗的86例Ⅲ、Ⅳ期压疮感染创面患者作为研究对象,根据住院号顺序编号,采用随机数字表法分为观察组和对照组,各43例;观察组予负压封闭引流术治疗,对照组采取换药治疗;以创面感染控制时间、创面愈合时间、McGill疼痛评分、创面面积、压疮愈合计分表(PUSH)评分、微血管数量、神经生长因子(NGF)为观察指标。结果:观察组感染控制时间、创面愈合时间均短于对照组,McGill疼痛评分低于对照组,差异有统计学意义(P<0.05);观察组治疗21 d时创面面积较治疗前明显缩小,PUSH评分较治疗前明显降低,与对照组比较,差异均有统计学意义(P<0.05);观察组与对照组相比在治疗7 d、14 d微血管数量及NGF阳性细胞数均比较多;观察组与对照组微血管数量及NGF阳性细胞数变化趋势有差别(P<0.05)。结论:负压封闭引流术较传统换药能更好的控制压疮创面感染,明显促进压疮创面血管和神经生成,提高创面愈合速度,是一种疗效较好的治疗方法。

Objective:To investigate the effects of vacuum sealing drainage on the blood vessels and nerve formation of wounds.Methods:Eighty-six patients with stageⅢandⅣpressure ulcer wounds treated in our hospital from January 2018 to December 2019 were selected as subjects,according to the order of admission,they were divided into observation group and control group randomly,43 cases each;observation group was treated with negative pressure closed drainage,and control group was treated with dressing.Wound cleaning time,wound healing time,McGill pain score,wound area,pressure ulcer healing score(PUSH)score,microvascular number,nerve growth factor(NGF)were observed.Results:The wound cleaning time and wound healing of the observation group were shorter than those of the control group,the McGill pain score was lower than that of the control group,and the difference was statistically significant(P<0.05);the wound area of the observation group was significantly smaller than that before treatment,and the PUSH score was significantly lower than that before treatment.The difference was statistically significant(P<0.05);compared with the control group,the observation group had more microvessels and NGF positive cells on the 7th and 14th days of treatment,the observation group and the control group had different changes in the number of microvessels and NGF positive cells(P<0.05).Conclusion:Negative pressure closed drainage can significantly promote the blood vessel and nerve formation of infected wounds in pressure wounds and improve the healing speed of wounds,it is an ideal therapy choice.