重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
23期
3019-3021,3024
,共4页
李云恺%陈丽艳%王惠%邱思强
李雲愷%陳麗豔%王惠%邱思彊
리운개%진려염%왕혜%구사강
臭氧%臭氧水%VSD%复杂创面%白细胞介素-1%成纤维细胞生长因子
臭氧%臭氧水%VSD%複雜創麵%白細胞介素-1%成纖維細胞生長因子
취양%취양수%VSD%복잡창면%백세포개소-1%성섬유세포생장인자
ozone%ozonated water%vacuum sealing drainage%complex wounds%interleukin-1%fibroblast growth factors
目的：探讨臭氧、臭氧水联合改良型负压封闭引流（VSD ）治疗复杂性创面的效果及局部成纤维细胞生长因子（FGF）、白细胞介素-1（IL-1）的变化。方法选择40例四肢严重皮肤软组织损伤患者为研究对象，随机分为臭氧＋VSD组、臭氧水＋ VSD组、VSD组与对照组，每组各10例，分别采用臭氧联合改良型VSD、臭氧水联合改良型VSD、VSD以及传统换药治疗。观察4种治疗方式对复杂性创面愈合、细菌感染以及局部FGF、IL-1水平的影响。结果对照组平均治疗时间为（31．5±6．6）d ，平均换药（15．4±3．9）次，感染率40％。VSD组5例接受2次VSD治疗，平均VSD治疗时间为（19．2±2．3）d ，感染率10％。臭氧＋ VSD组与臭氧水＋VSD组均经1次VSD治疗，平均VSD治疗时间分别为（14．9±2．7）d和（14．1±3．0）d ，无感染。臭氧＋VSD组和臭氧水＋VSD组创面愈合率最高，VSD组次之，对照组愈合率最低；细菌菌落数由高到低排列为对照组、VSD组、臭氧＋VSD组和臭氧水＋VSD组，组间比较差异有统计学意义（P＜0．05）。4组患者局部FGF、IL-1阳性细胞数量比较差异有统计学意义（P＜0．05）。结论臭氧水或臭氧联合负压封闭引流可降低IL-1，提高FGF表达，可缩短愈合时间、控制感染、提高复杂创面愈合率，且臭氧水联合治疗效果更好。
目的：探討臭氧、臭氧水聯閤改良型負壓封閉引流（VSD ）治療複雜性創麵的效果及跼部成纖維細胞生長因子（FGF）、白細胞介素-1（IL-1）的變化。方法選擇40例四肢嚴重皮膚軟組織損傷患者為研究對象，隨機分為臭氧＋VSD組、臭氧水＋ VSD組、VSD組與對照組，每組各10例，分彆採用臭氧聯閤改良型VSD、臭氧水聯閤改良型VSD、VSD以及傳統換藥治療。觀察4種治療方式對複雜性創麵愈閤、細菌感染以及跼部FGF、IL-1水平的影響。結果對照組平均治療時間為（31．5±6．6）d ，平均換藥（15．4±3．9）次，感染率40％。VSD組5例接受2次VSD治療，平均VSD治療時間為（19．2±2．3）d ，感染率10％。臭氧＋ VSD組與臭氧水＋VSD組均經1次VSD治療，平均VSD治療時間分彆為（14．9±2．7）d和（14．1±3．0）d ，無感染。臭氧＋VSD組和臭氧水＋VSD組創麵愈閤率最高，VSD組次之，對照組愈閤率最低；細菌菌落數由高到低排列為對照組、VSD組、臭氧＋VSD組和臭氧水＋VSD組，組間比較差異有統計學意義（P＜0．05）。4組患者跼部FGF、IL-1暘性細胞數量比較差異有統計學意義（P＜0．05）。結論臭氧水或臭氧聯閤負壓封閉引流可降低IL-1，提高FGF錶達，可縮短愈閤時間、控製感染、提高複雜創麵愈閤率，且臭氧水聯閤治療效果更好。
목적：탐토취양、취양수연합개량형부압봉폐인류（VSD ）치료복잡성창면적효과급국부성섬유세포생장인자（FGF）、백세포개소-1（IL-1）적변화。방법선택40례사지엄중피부연조직손상환자위연구대상，수궤분위취양＋VSD조、취양수＋ VSD조、VSD조여대조조，매조각10례，분별채용취양연합개량형VSD、취양수연합개량형VSD、VSD이급전통환약치료。관찰4충치료방식대복잡성창면유합、세균감염이급국부FGF、IL-1수평적영향。결과대조조평균치료시간위（31．5±6．6）d ，평균환약（15．4±3．9）차，감염솔40％。VSD조5례접수2차VSD치료，평균VSD치료시간위（19．2±2．3）d ，감염솔10％。취양＋ VSD조여취양수＋VSD조균경1차VSD치료，평균VSD치료시간분별위（14．9±2．7）d화（14．1±3．0）d ，무감염。취양＋VSD조화취양수＋VSD조창면유합솔최고，VSD조차지，대조조유합솔최저；세균균락수유고도저배렬위대조조、VSD조、취양＋VSD조화취양수＋VSD조，조간비교차이유통계학의의（P＜0．05）。4조환자국부FGF、IL-1양성세포수량비교차이유통계학의의（P＜0．05）。결론취양수혹취양연합부압봉폐인류가강저IL-1，제고FGF표체，가축단유합시간、공제감염、제고복잡창면유합솔，차취양수연합치료효과경호。
Objective To investigate the clinical effect of combination of ozone ,ozonated water and improved Vacuum Sealing Drainage(VSD) in healing complex wound ,and to observe the expression of fibroblast growth factors(FGF) and interleukin-1(IL-1) in its surface .Methods 40 patients with complex extremity trauma were selected and divided into 4 groups randomly .These 4 groups were Ozone+VSD group and Ozonated Water+ VSD group ,VSD group and Control group ,and received ozone combined VSD treatment ,ozonated water combined VSD treatment ,pure VSD treatment ,and traditional treatment .Each group contained 10 patients .Comparison of clinical effect ,bacteria loads and the expression of FGF and IL-1 in wound surface was made in 4 groups . Results The average cure time ,average replacing frequency and infection rate in Control group were (31 .5 ± 6 .6)days ,(15 .4 ± 3 .9) times and 40% respectively .The average cure time ,twice VSD cases and infection rate in VSD group were (19 .2 ± 2 .3)days , 5 cases and 10% respectively .There were no case of infection or received twice VSD treatment in Ozone + VSD group and Ozonated Water+VSD group .The average cure time were (14 .9 ± 2 .7) days and (14 .1 ± 3 .0) days .The Ozone+ VSD group and Ozonated Water+VSD group had best clinical effect ,and the Ozonated Water+ VSD group had least bacteria loads in wound surface (P<0 .05) .The expression of FGF and IL-1 in 4 group had obvious differences ,and it had statistical significance(P<0 .05) .Conclusion Both ozone or ozonated water combined VSD treatment could decrease IL-1 and increase FGF expression ,accelerate recovery time ,inhibit bacterial infection ,especially ozonated water combined VSD treatment had better effect .
