封闭式负压引流技术对人慢性创面血管生成的影响

Effect of vacuum-assisted closure on angiogenesis of human chronic wound healing

目的:研究封闭式负压引流技术(Vacuum-AssistedClosure,VAC)对人慢性创面治疗前后血管生成犤血管内皮细胞生长因子(vascularendothelialgrowthfactor,VEGF),CD34犦的影响。方法:对5例慢性创面患者给予持续性VAC治疗(-15.96kPa压力),分别于吸引前以及吸引后1,3,5,7d切取创缘组织,采用免疫组织化学技术,检测VEGF,CD34表达及其标记指数、微血管密度的变化。结果:负压吸引前,VEGF在创缘组织真皮浅层血管内皮细胞中偶见阳性表达,随VAC时间的延长,真皮层中血管内皮细胞、成纤维细胞出现VEGF阳性表达,标记指数增加(F=41.819,P<0.05)。CD34在VAC治疗后表达的微血管密度,明显增强(F=21.691,P<0.05)。结论:VAC能明显增强在创缘组织真皮浅层血管内皮细胞、成纤维细胞的增殖和微血管密度,促进慢性创面肉芽组织生长。

AIM:To investigate the effect of vacuum-assis te d closure(VAC)on angio-genesivascular endothelial growth factor(VEGF),C D3before and after the treatment of human wound chronic healing.METHODS:T issues of chronic wound margin were taken from 5patients before and 1,3,5 ,7days after contin uous VAC treatment (pressure of -15.96kPa).The ex pression and changes of labelindex and microvascular density of VEGF,CD34were detected b y immunohistochemistric method.RESULTS:Before negative pressure,l ittle positive expression were observed at the tissues of chronic wound margin. As the time of VAC prolonged,vascula r endothelial cells and fibroblast sh owed VEGF positive expression and th e label index was increased(F=41.819, P<0.05).After VAC treatment,microvas-cular density of CD34was obvious ly i ncreased(F=21.691,P<0.05).The technique of VAC can obviously in crease the prolifer-ative activity of vascular endothel ial ce ll and fibroblast and microvascular density,and facilitate the formation of gra nulation tissue of chronic w ound healing.