红外线局部照射联合皮肤再生医疗技术治疗开腹胃肠外科术后切口感染效果及对IL-4/IL-13/STAT6信号通路影响

Local infrared radiation combined with skin regenerative medical technology for treatment of incision infection after open gastrointestinal surgery:Efficacy and influence on IL-4/IL-13/STAT6 signaling pathway

背景切口感染是开腹胃肠外科术常见并发症及临床亟待解决的问题.红外线局部照射联合皮肤再生医疗技术能通过改善切口局部血液循环,降低致痛化学介质作用,抑制切口过度炎症反应,并通过加快渗出物吸收,缓解局部炎症.目的探讨红外线局部照射联合皮肤再生医疗技术治疗开腹胃肠外科术后切口感染效果及对白介素-4(interleukin-4,IL-4)/白介素-13(interleukin-13,IL-13)/转录激活子6(signal transducer and activator of transcription 6,STAT6)信号通路影响.方法按照1:1试验设计原则和电脑随机数字表法将2019-03/2021-06我院收治的66例开腹胃肠外科术后切口感染患者,随机分为对照组、实验组进行前瞻性研究,各33例.两组均给予抗菌药物治疗,在此基础上,对照组给予皮肤再生医疗技术,实验组给予红外线局部照射联合皮肤再生医疗技术.比较两组疗效、炎症指标[C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)、白细胞(WBC)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、IL-4 mRNA、IL-13 mRNA、STAT6 mRNA、换药次数、红肿痛缓解时间、病原菌培养转阴时间、住院时间、温哥华瘢痕量表(vancouver scar scale,VSS)评分.结果两组疗效分布情况比较,差异有统计学意义,实验组显效率为75.76%,高于对照组的42.42%(P<0.05);实验组治疗3 d后、治疗5 d后CRP、PCT、WBC、TNF-α低于对照组(P<0.05);实验组治疗3 d后、治疗5 d后IL-4 mRNA、IL-13 mRNA、STAT6 mRNA低于对照组(P<0.05);实验组换药次数、红肿痛缓解时间、病原菌培养转阴时间、住院时间低于对照组(P<0.05);实验组VSS量表色泽、血管、柔软性、厚度、疼痛评分低于对照组(P<0.05).结论红外线局部照射联合皮肤再生医疗技术治疗开腹胃肠外科术后切口感染,能增强疗效,改善炎症反应与切口愈合质量,加快患者临床症状体征缓解和恢复进程.

BACKGROUND Incision infection is a common complication of open gastrointestinal surgery and an urgent clinical problem to be solved.Infrared local irradiation combined with skin regeneration medical technology can improve the local blood circulation of the incision,reduce the effect of painful chemical mediators,inhibit excessive inflammation of the incision,and alleviate local inflammation by accelerating the absorption of exudate.AIM To investigate the efficacy of local infrared irradiation combined with skin regenerative medical technology in the treatment of wound infection after open gastrointestinal surgery and the influence on the interleukin-4(IL-4)/interleukin-13(IL-13)/activator of transcription 6(STAT6)pathway.METHODS According to the 1:1 trial design principle and the computerized random number table method,66 patients with incisional infection after open gastrointestinal surgery admitted to our hospital from March 2019 to June 2021 were randomly divided into a control group and an experimental group for prospective research,with 33 cases in each group.Both groups were treated with antibacterial drugs.On this basis,the control group was given skin regenerative medical technology,and the experimental group was given infrared local irradiation combined with skin regenerative medical technology.Clinical efficacy,inflammation indicators[C-reactive protein(CRP),procalcitonin(PCT),white blood cells(WBC),and tumor necrosis factor-α(TNF-α)],IL-4 mRNA,IL-13 mRNA,STAT6 mRNA,number of dressing changes,time to relief of redness,swelling,and pain,time for pathogen culture to turn negative,length of hospital stay,and Vancouver scar scale(VSS)score were compared between the two groups.RESULTS The therapeutic effects differed significantly between the two groups.The effective rate of the experimental group was 75.76%,which was higher than that(42.42%)of the control group(P<0.05).At 3 d and 5 d after treatment,CRP,PCT,WBC,and TNF-α,as well as the mRNA expression of IL-4,IL-13,and STAT6 were significantly lower in the experimental group than in the control group(P<0.05).The number of dressing changes,time to relief of redness,swelling,and pain,time for pathogen culture to turn negative,and length of hospital stay in the experimental group were significantly lower than those of the control group(P<0.05).The color,blood vessel,flexibility,thickness,and pain scores of the experimental group were better than those of the control group(P<0.05).CONCLUSION Infrared local irradiation combined with skin regenerative medical technology to treat incision infections after open gastrointestinal surgery can enhance the efficacy,improve the inflammatory response and the quality of incision healing,and accelerate the relief of clinical symptoms and signs and the recovery process.