眼镜蛇咬伤溃疡创面炎症细胞趋化及血管内皮因子表达的研究

Study on chemotaxis of inflammatory cells and expression of vascular endothelial factors in cobra bite ulcer wound

目的分析眼镜蛇咬伤溃疡创面炎症细胞趋化及血管内皮因子的表达情况。方法回顾性分析2018年1月至2022年3月我院收治的30例眼镜蛇咬伤患者临床资料,其中15例接受常规清创、换药及伤口肿胀处给予50%硫酸镁外敷治疗的患者为甲组,另15例行负压封闭吸引技术及伤口肿胀处给予飞龙汤外敷(本院经验方)治疗的患者为乙组,比较两组患者溃疡面炎症细胞趋化[(巨噬细胞、白介素-6(IL-6)、中性粒细胞计数(NEUT)、C反应蛋白(CRP)]及血管内皮因子表达情况、创面疼痛程度及恢复(肿胀消退、创面愈合及住院时间)情况。结果治疗第7 d时,乙组患者的巨噬细胞含量高于甲组,IL-6、NEUT及CRP水平均低于甲组,血管内皮因子表达高于甲组,而且乙组治疗第3天及第7天的视觉模拟疼痛量表(VAS)评分均低于甲组,肿胀消退、创面愈合及住院时间均短于甲组,差异均有统计学意义(均P<0.05)。结论眼镜蛇咬伤患者溃疡创面予以负压封闭吸引技术配合飞龙汤外敷干预,能有效调节炎症细胞趋化,提高血管内皮因子的表达,促进创面修复。

Objective To analyze the chemotaxis of inflammatory cells and the expression of vascular endothelial factors in cobra bite ulcer.Methods Clinical data of 30 patients with cobra bite treated in our hospital from January 2018 to March 2022 were retrospectively analyzed.Among them,15 patients in group A who received routine debridement,dressing change and 50%magnesium sulfate external treatment for wound swelling were treated.The other 15 patients who were treated with negative pressure sealing suction technique and Feilong decoction(our hospital's empirical formula)were group B.The chemoattractant[macrophages,interleukin 6(IL6),neutrophil count(NEUT),C-reactive protein(CRP)]expression of ulcerative surface inflammatory cells and vascular endothelial factors,the degree of wound pain and recovery(swelling reduction,wound healing and length of hospital stay)were compared between the two groups.Results On the 7th day of treatment,the content of macrophages in group B was higher than that in group A,the levels of IL6,NEUT and CRP were lower than those in group A,the expression of vascular endothelial factor was higher than that in group A,and the visual analog pain scale(VAS)score of group B was lower than that in group A on the 3rd and 7th day of treatment.Swelling regression,wound healing and hospital stay were shorter than those in group A,with statistical significance(all P<0.05).Conclusion The negative pressure sealing and suction technique combined with Feilong decoction can effectively regulate the chemotaxis of inflammatory cells,increase the expression of vascular endothelial factors,and promote wound repair in patients with cobra bite.