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目的观察负压封闭引流(VSD)技术治疗后兔创面超敏C-反应蛋白(hs-CRP)和血浆纤维连接蛋白(Fn)水平的变化,探讨VSD促进创面愈合的作用机制。方法复制兔创面模型16只,随机分为两组,常规组(n=8,创面每日消毒、换药及包扎治疗)和VSD组(n=8,创面行VSD敷料护创引流治疗)。在建模前(0时)及建模后7 d内各时间点(6 h、12 h、1 d、3 d、5 d和7 d),抽取外周静脉血检测hs-CRP及Fn,观察比较两检测指标的变化情况。结果建模前两组外周静脉血hs-CRP及Fn含量差异无统计学意义(P>0.05),建模后两组指标含量均不同程度增高。自12 h时间点VSD组hs-CRP含量与常规组比较差异有统计学意义(P<0.05),VSD组hs-CRP峰值出现在第1天,为(43.81±3.15)mg/L,而常规组hs-CRP峰值出现在第3天,为(70.84±4.82)mg/L。第1天时间点VSD组Fn与常规组比较差异有统计学意义(P<0.05),两组Fn的峰值均出现在第3天,分别为(161.53±8.60)mg/L和(109.83±9.18)mg/L,但随后VSD组Fn维持在一个高浓度的平台期,下降趋势不明显。结论 VSD技术可能通过引流清除创面坏死组织和渗出液,改善创面微循环,促成纤维细胞增殖,早期降低血浆hs-CRP含量,增加Fn含量,减少炎症反应,加速创面愈合。
Objective To observe the changes of hs-CRP and Fn in rabbit wounds after treatment with negative-pressure closed drainage (VSD), and to explore the mechanism of VSD in promoting wound healing. Methods Sixteen rabbits were randomly divided into two groups. The rabbits in the conventional group (n = 8, daily disinfection of the wound, dressing change and bandaging) and the VSD group (n = 8) were treated with VSD dressing. The levels of hs-CRP and Fn in peripheral venous blood were measured before modeling (at 0:00) and within 7 days after modeling (6 h, 12 h, 1 d, 3 d, 5 d and 7 d) Compare the changes of two test indicators. Results There was no significant difference in hs-CRP and Fn levels between the two groups before model establishment (P> 0.05). After modeling, the content of hs-CRP and Fn in both groups increased to some extent. The hs-CRP level in VSD group was significantly lower than that in the control group at 12 h (P <0.05). The peak value of hs-CRP in VSD group was (43.81 ± 3.15) mg / L on the first day, Group hs-CRP peak appeared on the 3rd day, (70.84 ± 4.82) mg / L. The difference of Fn in VSD group was statistically significant (P <0.05) on the first day, and the peak of Fn in both groups appeared on the third day (161.53 ± 8.60 mg / L and (109.83 ± 9.18 ) mg / L, but then Fn in the VSD group maintained at a high plateau stage, the downward trend is not obvious. Conclusion VSD may remove wound necrotic tissue and exudate by drainage, improve wound microcirculation, promote fibroblast proliferation, reduce plasma hs-CRP content early, increase Fn content, reduce inflammation and accelerate wound healing.