局部臭氧联合持续负压吸引对高位肛瘘术后患者Bax、P53、caspase-3表达水平及伤口愈合的影响

Effect of Local Ozone Combined with Continuous Negative Pressure Suction on Expression of Bax, P53, Caspase-3 and Wound Healing in Patients with High Anal Fistula Surgery

目的:探讨局部臭氧联合持续负压吸引对高位肛瘘术后患者Bax、P53、caspase-3表达水平及伤口愈合的影响。方法:选取2018年6月-2021年3月东莞市滨海湾中心医院收治的高位肛瘘切除术患者50例,采用随机数字表法分为联合组与臭氧组,每组25例。臭氧组术后给予局部臭氧治疗,联合组术后进行局部臭氧联合持续负压吸引治疗,对比两组临床疗效、愈合时间、愈合率、肛门疼痛积分及肛门肿胀评分以及凋亡分子Bax、P53、caspase-3的表达量。结果:联合组总有效率为96.00%,高于臭氧组的76.00%(P<0.05)。联合组创面愈合时间短于臭氧组,术后7、14 d创面愈合率均高于臭氧组,差异均有统计学意义(P<0.05)。联合组术后2 d肛门VAS评分与臭氧组相比,差异无统计学意义(P>0.05);联合组术后7、14 d肛门VAS评分均低于臭氧组(P<0.05)。联合组术后2、7、14 d肿胀积分均低于臭氧组(P<0.05)。两组术后5、10、15 d的caspase-3、Bax、P53表达量比较,差异均有统计意义(P<0.05)。结论:局部臭氧联合持续负压吸引治疗可促进高位肛瘘术后创面愈合,提高临床疗效,减轻肛门疼痛与肿胀,抑制凋亡分子的表达,值得临床推广应用。

Objective: To investigate the effect of local ozone combined with continuous negative pressure suction on the expression levels of Bax, P53, and caspase-3 and wound healing in patients with high anal fistula after surgery. Method: A total of 50 patients underwent high anal fistula resection in Binhaiwan Central Hospital of Dongguan City from June 2018 to March 2021 were selected and divided into the combined group and the ozone group by random number table method, 25 cases in each group. The ozone group received local ozone therapy after surgery, and the combination group received local ozone combined with continuous negative pressure suction therapy after surgery. The clinical efficacy, healing time, healing rate, anal pain score, anal swelling score and apoptosis molecule Bax, P53, caspase-3 expression levels were compared between two groups. Result: The total effective rate of the combination group was 96.00%, which was higher than 76.00% of the ozone group(P<0.05). The wound healing time of the combination group was shorter than that of the ozone group, and the wound healing rates at 7 and 14 d after surgery were higher than those of the ozone group, the differences were statistically significant(P<0.05). There was no significant difference in the anal VAS score between two groups at 2 d after surgery, and the anal VAS scores at 7 and 14 d after surgery were significantly lower than those in the ozone group(P<0.05). The swelling scores of the combination group at 2, 7 and 14 d after surgery were significantly lower than those of the ozone group(P<0.05). The protein expressions of caspase-3, Bax and P53 of the combination group at 5, 10 and 15 d after surgery were significantly lower than those of the ozone group(P<0.05). Conclusion: Local ozone combined with continuous negative pressure suction therapy can promote wound healing after high anal fistula surgery, improve clinical efficacy, reduce anal pain and swelling, and inhibit the expression of apoptotic molecules, it is worthy of clinical application.