中国现代普通外科进展2024,Vol.27Issue(2) :134-138.DOI:10.3969/j.issn.1009-9905.2024.02.009

常规手术加负压吸引疗法治疗慢性下肢静脉溃疡效果观察

Negative pressure wound therapy promotes autologous skin transplantation by alleviating inflammatory reaction in pa-tients with chronic venous leg ulcer

袁旭松 张健 徐露 林金荣
中国现代普通外科进展2024,Vol.27Issue(2) :134-138.DOI:10.3969/j.issn.1009-9905.2024.02.009

常规手术加负压吸引疗法治疗慢性下肢静脉溃疡效果观察

Negative pressure wound therapy promotes autologous skin transplantation by alleviating inflammatory reaction in pa-tients with chronic venous leg ulcer

袁旭松 1张健 2徐露 1林金荣1
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作者信息

  • 1. 上海合川莱茵中医医院 普外科(上海 201103)
  • 2. 上海市第六人民医院 血管外科(上海 200233)
  • 折叠

摘要

目的:探讨负压吸引疗法(NPWT)控制慢性下肢静脉溃疡(VLU)炎症反应,为溃疡创面自体皮肤移植创造条件的机制.方法:2018年6月至2021年12月,29例慢性下肢静脉溃疡患者,分为对照组(n=13)和观察组(n=16).对照组采取常规静脉曲张手术加清创术,术后溃疡创面隔日常规换药;观察组除同对照组治疗外,术后溃疡创面持续负压引流1周.采集两组患者溃疡创面组织标本行组织学观察;ELISA检测IL-1 β和IL-18蛋白水平变化;Western blotting检测凋亡相关斑点样蛋白(ASC)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、半胱氨酸天冬氨酸蛋白酶(Caspase-1)蛋白水平变化;生存曲线分析评估溃疡创面可行植皮时间.结果:术后7 d,观察组溃疡创面组织炎症反应较对照组明显减轻;观察组IL-1β和IL-18水平和ASC、NLRP3及Caspase-1水平均明显低于对照组;观察组溃疡创面可行植皮术的时间明显低于对照组.结论:NPWT通过抑制慢性下肢静脉溃疡创面组织炎症反应,为短时间内行创面自体皮肤移植创造条件.

Abstract

Objective:To investigate the mechanism of inhibiting inflammatory response by negative pressure wound therapy in the chronic venous leg ulcer.Method:The clinical data of 29 patients with chronic VLU treated in Hechuan-Rhine Traditional Chinese Medicine Hospital of Shanghai from June 2018 to December 2021 were collected.According to different treatment meth-ods,the patients were divided into the control group(n=13)and the observation group(n=16).The control group adopted routine varicose vein operations and debridement,routine dressing change was performed on the VLU wound every other day after operation.The observation group adopted debridement and then NPWT on the basis of routine varicose vein operations,the VLU wound was continuously drained with negative pressure for 1 week after operation.IL-1β and IL-18 levels were measured with ELISA.ASC、NLRP3 and Caspase-1 levels were detected with Western blot-ting.The autologous skin transplantation time of the two groups were calculated by survival curve analysis.Results:The inflammatory response was milder in the observation group than in the con-trol group 7 days after operation.The results of ELISA showed that the levels of IL-1 p and IL-18 in the observation group were lower than those in the control group.The results of Western blotting showed that the relative expression levels of ASC、NLRP3 and Caspase-1 in the observation group were lower than those in the control group.The survival curve analysis showed that the autologous skin transplantation time of the observation group was less than the control group.Conclusion:The inflammatory response can be distinctly alleviated by NPWT in the VLU,leading to better condi-tions for autologous skin transplantation within a short period.

关键词

下肢静脉溃疡/负压封闭引流技术/创面炎症反应/自体皮肤移植

Key words

Venous leg ulcer/Negative pressure wound therapy/Wound inflammation reaction/Autologous skin transplantation

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出版年

2024
中国现代普通外科进展
山东大学

中国现代普通外科进展

CSTPCD
影响因子:0.993
ISSN:1009-9905
参考文献量11
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