CAJ | 학술논문

目的探讨负压封闭引流(VSD)技术联合臭氧水冲洗治疗铜绿假单胞菌感染性创面的疗效.方法将40只Wistar大鼠随机分为5组(n=8):VSD联合5、10 mg/L臭氧水冲洗组、VSD联合庆大霉素冲洗组、VSD联合生理盐水冲洗组、常规换药组.成功建立铜绿假单胞菌感染模型后行病灶清除、安置VSD装置.术后VSD联合冲洗组经冲洗管分别注入5、10 mg/L臭氧水、庆大霉素及生理盐水冲洗,1次/12h,常规换药组换药,1次/d,共治疗5d.每组造模时、造模后及治疗5 d时行白细胞总数、局部组织肿瘤坏死因子-α(TNF-α)及表皮生长因子(EGF)含量检测.治疗5 d时局部组织行HE染色观察炎性反应. 结果治疗5 d时VSD联合5、10 mg/L臭氧水冲洗组TNF-α表达[(26.93±3.57) 、(24.47 ±3.08) pg/mL]明显低于VSD联合庆大霉素冲洗组、VSD联合生理盐水冲洗组、常规换药组[(34.98±3.17)、(45.76 ±4.17)、(49.07 ±4.27) pg/mL],EGF表达[(172.49 ±6.47)、(185.03 ±5.56) pg/mL]明显高于后3组[(124.51 ±6.75)、(90.81 ±4.17)、(85.72 ±4.67) pg/mL],差异均有统计学意义(P＜0.05).VSD联合10 mg/L臭氧水冲洗组无明显分泌物渗出,大量肉芽组织生长,HE染色显示炎性细胞浸润最少,白细胞总数恢复正常水平.结论 VSD联合5、10 mg/L臭氧水冲洗治疗感染性创面的疗效明显优于常规换药及VSD联合庆大霉素或生理盐水冲洗,其中VSD联合10 mg/L臭氧水冲洗疗效最好.
목적 탐토부압봉폐인류(VSD)기술연합취양수충세치료동록가단포균감염성창면적료효.방법 장40지Wistar대서수궤분위5조(n=8):VSD연합5、10 mg/L취양수충세조、VSD연합경대매소충세조、VSD연합생리염수충세조、상규환약조.성공건립동록가단포균감염모형후행병조청제、안치VSD장치.술후VSD연합충세조경충세관분별주입5、10 mg/L취양수、경대매소급생리염수충세,1차/12h,상규환약조환약,1차/d,공치료5d.매조조모시、조모후급치료5 d시행백세포총수、국부조직종류배사인자-α(TNF-α)급표피생장인자(EGF)함량검측.치료5 d시국부조직행HE염색관찰염성반응. 결과 치료5 d시VSD연합5、10 mg/L취양수충세조TNF-α표체[(26.93±3.57) 、(24.47 ±3.08) pg/mL]명현저우VSD연합경대매소충세조、VSD연합생리염수충세조、상규환약조[(34.98±3.17)、(45.76 ±4.17)、(49.07 ±4.27) pg/mL],EGF표체[(172.49 ±6.47)、(185.03 ±5.56) pg/mL]명현고우후3조[(124.51 ±6.75)、(90.81 ±4.17)、(85.72 ±4.67) pg/mL],차이균유통계학의의(P＜0.05).VSD연합10 mg/L취양수충세조무명현분비물삼출,대량육아조직생장,HE염색현시염성세포침윤최소,백세포총수회복정상수평.결론 VSD연합5、10 mg/L취양수충세치료감염성창면적료효명현우우상규환약급VSD연합경대매소혹생리염수충세,기중VSD연합10 mg/L취양수충세료효최호.
Objective To study the effect of vacuum sealing drainage (VSD) plus ozone water flushing in treatment of pseudomonas aeruginosa infected wounds.Methods Forty Wistar rats were randomly divided into 5 equal groups.Groups A and B received treatment of VSD plus 5 and 10 mg/L ozone water flushing respectively,group C VSD plus gentamycin flushing,group D VSD plus normal saline flushing and group E routine dressing.After models of pseudomonas aeruginosa infected wound were established in the 5 groups,debridement was performed and VSD equipnent installed in groups A,B,C,and D.Flushings with 5 and 10 mg/L ozone water,gentamycin and normal saline were carried out respectively in flushing groups every 12 hours and routine dressing was changed once daily after operation,all for continuous 5 days.The WBC,tumor necrosis factor-alpha (TNF-α) and epidermal growth factor (EGF) were detected in every group during modeling,after modeling and 5 days after operation.HE staining of local tissues was conducted to observe inflammatory reactions 5 days after operation.Results At 5 days after operation,the TNF-α expressions in groups A and B (26.93 ± 3.57 pg/mL and 24.47 ± 3.08 pg/mL) were significantly lower than in the other 3 groups (34.98 ±3.17 pg/mL,45.76 ±4.17 pg/mL and 49.07 ±4.27 pg/mL],but the EGF expressions in groups A and B (172.49 ±6.47 pg/mL and 185.03 ±5.56 pg/mL) significantly higher than in the other 3 groups (124.51 ±6.75 pg/mL,90.81 ±4.17 pg/mL and 85.72 ±4.67 pg/mL) (P ＜0.05).In group B,there was no obvious exudation but massive growth of granulation tissue; HE staining showed the least infiltration of inflammatory cells and normal WBC level.Conclusion VSD plus 5 and 10 mg/L ozone water flushing show a better effect on healing of pseudomonas aeruginosa infected wounds than routine dressing and VSD plus gentamycin or normal saline flushing,especially when ozone is at a concentration of 10 mg/L in water.