CAJ | 학술논문

目的：探讨封闭负压引流（ VAC）对兔压力性溃疡创面组织水肿及血流量的影响。方法10只新西兰白兔，建立兔耳压力性溃疡模型，每只左、右耳各1个直径2 cm的圆形溃疡创面，随机分为VAC组和对照组，分别采用VAC治疗及常规包扎，肉眼观察创面变化及记录愈合时间，于治疗前及治疗后3 d、7 d、14 d采用干湿重法检测两组创面组织的含水量，用激光多普勒血流仪测定创面血流量，并进行耳静脉血内皮素（ET-1）和一氧化氮（NO）含量的测定。结果创面应用VAC可促进坏死组织清除，减轻组织肿胀，促进肉芽组织生长。 VAC组平均愈合时间为（18±1）d，较对照组的（21±2）d明显缩短（P＜0．05）。治疗前两组创面组织含水量、血流量及血浆ET-1、NO含量差异无统计学意义（ P＞0．05），VAC组创面组织含水量、血浆ET-1含量在治疗后3 d、7 d、14 d 均低于对照组（P ＜0．05），而血流量、血浆 NO 含量则均高于对照组（P ＜0．05）。结论 VAC可促进兔压力性溃疡创面愈合，可能与其促进坏死组织清除、减轻组织水肿、改善创面血流量等有关。
목적：탐토봉폐부압인류（ VAC）대토압력성궤양창면조직수종급혈류량적영향。방법10지신서란백토，건립토이압력성궤양모형，매지좌、우이각1개직경2 cm적원형궤양창면，수궤분위VAC조화대조조，분별채용VAC치료급상규포찰，육안관찰창면변화급기록유합시간，우치료전급치료후3 d、7 d、14 d채용간습중법검측량조창면조직적함수량，용격광다보륵혈류의측정창면혈류량，병진행이정맥혈내피소（ET-1）화일양화담（NO）함량적측정。결과창면응용VAC가촉진배사조직청제，감경조직종창，촉진육아조직생장。 VAC조평균유합시간위（18±1）d，교대조조적（21±2）d명현축단（P＜0．05）。치료전량조창면조직함수량、혈류량급혈장ET-1、NO함량차이무통계학의의（ P＞0．05），VAC조창면조직함수량、혈장ET-1함량재치료후3 d、7 d、14 d 균저우대조조（P ＜0．05），이혈류량、혈장 NO 함량칙균고우대조조（P ＜0．05）。결론 VAC가촉진토압력성궤양창면유합，가능여기촉진배사조직청제、감경조직수종、개선창면혈류량등유관。
Objective To investigate the effects of vacuum-assisted closure ( VAC ) on wound edema and blood flow in rabbits with pressure ulcers .Methods Ten New Zealand white rabbits with pressure ulcers diameter of 2 cm in both ears were enrolled into the study for establishing the rabbit model of pressure ulcers .They were randomly divided into group VAC and control group .The rabbits in the group VAC were treated with VAC while in the control group were treated with routine enswathement .The changes of the wound and wound healing time were macroscopically observed .The tissue water content in wound was measured by the method of wet-dry subtraction in both groups before treatment as well as 3,7 and 14 days after treatment,the blood flow was recorded by laser Doppler flowmetry ,and the ear vein blood samples were obtained for evaluation of the contents of edothelin-1 ( ET-1 ) and nitric oxide ( NO ) . Results After treatment with VAC ,necrotic tissue was cleaned out quickly ,tissue ederna was alleviated and granulation tissue growth was accelerated.The average wound healing time was (18 ±1)days in the group VAC,which was significantly shorter in the control group[(21 ±2) days,P<0.05].Before treatment,there were no significant differences in the tissue water content,blood flow,the contents of plasma ET-1 and NO between two groups (P>0.05).The tissue water content in wound and the content of plasma ET-1 significantly decreased while the blood flow and the content of plasma NO significantly increased in the group VAC in contrast with those in the control group 3,7 and 14 days after treatment (P<0.05).Conclusion The healing-promoting effect of VAC on pressure ulcers in rabbits may be associated with promoting elimination of wound necrotic tissue ,alleviating tissue edema and improving blood flow .