祛腐生肌纱条联合自制VAC治疗VLU临床疗效及对MMP-2、TIMP-2表达的影响

Clinical Efficacy of Qufushengji Gauze Combined with Self-made VAC in the Treatment of VLU and its Effect on the Expression of MMP-2 and TIMP-2

目的观察祛腐生肌纱条联合自制负压封闭引流(VAC)治疗下肢静脉性溃疡(VLU)的临床疗效,观察分泌物中MMP-2和TIMP-2表达变化。方法选取2016年1月-2020年12月在武山县人民医院外科住院或门诊治疗的76例下肢VLU患者为研究对象,按照随机数字表法分为治疗组和对照组,各38例。治疗组应用祛腐生肌纱条联合自制VAC换药治疗,对照组应用清创胶和德湿妥换药治疗。比较两组创面缩小率、愈合率、愈合时间,测量分泌物中MMP-2和TIMP-2的表达情况。结果治疗组治疗后3、7、14、28 d创面缩小率大于对照组(P<0.05);治疗组创面愈合率高于对照组,治愈时间低于对照组(P<0.05);两组治疗后3、7、14 d创面分泌物内MMP-2水平均低于治疗前,且治疗组低于对照组(P<0.05);两组创面分泌物内TIMP-2水平呈先升后降趋势;治疗组治疗后3、7 d TIMP-2水平高于对照组,治疗后14 d TIMP-2水平低于对照组(P<0.05)。结论祛腐生肌纱条联合自制VAC可促进创面愈合,其机制可能与调控MMP-2及TIMP-2有关。

Objective To observe the clinical efficacy of Qufushengji gauze combined with self-made VAC in the treatment of VLU,and to observe its effect on the expression of MMP-2 and TIMP-2.Methods A total of 76 patients with lower limb VLU who were hospitalized or outpatient in the Department of Surgery,Wushan County People's Hospital from January 2016 to December 2020 were selected and divided into treatment group and control group according to random number table method,with 38 cases in each group.The treatment group was treated with Qufushengji gauze combined with self-made VAC dressing change,and the control group was treated with Qingchuangjiao and Deshituo dressing change.The wound reduction rate,healing rate and healing time were compared between the two groups.The expressions of MMP-2 and TIMP-2 in secretions were measured.Results The wound reduction rate of the treatment group at 3,7,14 and 28 d after treatment was higher than that of the control group(P<0.05).The wound healing rate of the treatment group was higher than that of the control group,and the healing time was lower than that of the control group(P<0.05).The levels of MMP-2 in wound secretions at 3,7 and 14 days after treatment in the two groups were lower than those before treatment,and the treatment group was lower than the control group(P<0.05).The level of TIMP-2 in wound secretions of the two groups showed a trend of first increase and then decrease;the TIMP-2 level of the treatment group was higher than that of the control group at 3 and 7 days after treatment,and the level of TIMP-2 was lower than that of the control group at 14 days after treatment(P<0.05).Conclusion The combination of Qufushengji gauze and self-made VAC can promote wound healing,and its mechanism may be related to the regulation of the expression of MMP-2 and TIMP-2.