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目的:探讨不同负压大小下的封闭负压引流术(vacuum sealing drainage,VSD)在治疗犬胸壁全层缺损创面愈合的效果。方法:25只健康成年犬的右胸壁制作3cm×4cm大小的全层缺损,随机分为5组,所有胸壁缺损处安装一次性封闭式负压吸引器,手动抽吸负压排出胸膜腔气体产生负压,致伤24小时后复查CT观察气胸情况;然后按照压力表显示调节负压至60kpa,40kpa,20kpa,10kpa,0kpa吸引胸壁,比较五组1d,3d,5d的伤口液体引流量,胸膜闭合时间;5d时伤口取材做HE染色及CD34免疫组化染色观察伤口愈合情况。结果:在60kpa和40kpa负压吸引下,1天引流液体量最多,分别为77.6±6.62 ml,77.8±4.97 ml;胸膜闭合最快,分别为3.2±1.30天,3.6±0.55天,但是60kpa组有一只犬血气分析显示为Ⅰ型呼吸衰竭;HE染色和CD34免疫组化染色显示各组均有肉芽组织增生及血管新生,且40kpa和60kpa负压组肉芽组织和血管密度明显多于其他组,二者之间无明显差异。结论:封闭负压吸引器对胸壁全层缺损创面有明显治疗作用,并且在40kpa负压下治疗效果最好而且安全。
Objective: To investigate the effect of vacuum sealing drainage (VSD) on the healing of full-thickness thoracic wall defects in dogs under different negative pressure. Methods: The full thickness defects of 3 cm × 4 cm in the right chest wall of 25 healthy adult dogs were randomly divided into 5 groups. One-time closed negative pressure suction device was installed on all the chest wall defects and the negative suction pressure was manually discharged to generate pleural cavity gas Negative pressure, 24 hours after injury to review the CT observation of pneumothorax; then adjust the negative pressure in accordance with the pressure gauge to 60kpa, 40kpa, 20kpa, 10kpa, 0kpa to attract the chest wall, compared five groups 1d, 3d, 5d wound fluid drainage, pleural The wounds were harvested at day 5 for HE staining and CD34 immunohistochemistry for wound healing. Results: Under the negative pressure of 60kpa and 40kpa, the volume of liquid drained in one day was the highest (77.6 ± 6.62 ml and 77.8 ± 4.97 ml, respectively); the pleural closure was the fastest (3.2 ± 1.30 days and 3.6 ± 0.55 days respectively) A dog blood gas analysis showed type Ⅰ respiratory failure; HE staining and CD34 immunohistochemical staining showed granulation tissue proliferation and angiogenesis in each group, and 40kpa and 60kpa negative pressure granulation tissue and vascular density was significantly more than other groups, No significant difference between the two. Conclusion: The closed vacuum aspirator has a significant therapeutic effect on the full-thickness defect of the chest wall, and it is the best and safe to treat under the negative pressure of 40kPa.