封闭负压引流对兔糖尿病溃疡创面组织愈合影响的观察

目的:探讨封闭负压引流(VAC)对兔糖尿病溃疡创面组织愈合的影响及其可能机制。方法:采用四氧嘧啶法建立兔糖尿病溃疡模型,设空白对照组和实验组(对照组创面采用常规包扎治疗处理,实验组创面则采用VAC处理),观察和比较两组动物的创面肉眼观、愈合时间,在致伤前、致伤后3 d、7 d、14 d取创面软组织,检测和比较两组动物的创面组织含水量、血流量以及血浆ET-1和NO含量。结果:与对照组比较,实验组动物的创面肿胀及分泌物得到明显控制,创面坏死组织的清除与肉芽组织的生长明显加快,平均愈合时间明显缩短(P0.05);致伤后3 d、7 d和14 d,创面组织含水量与血浆ET-1含量明显下降(P0.05),创面组织血流量与血浆NO含量明显增加(P0.05)。结论:VAC对兔糖尿病溃疡创面组织的愈合可起到积极的促进作用,这可能与其增加血浆NO含量及降低ET-1的含量有关,其具体机制尚有待于进一步的研究。

Observation on the Effect of Vacuum-assisted Closure on Healing of Rabbits with Diabetic Ulcers

Objective:To observe the influence and its possible mechanisms of vacuum-assisted closure (VAC) on the healing of rabbits with diabetic ulcer.Methods:A rabbit model of diabetic ulcer was established by alloxan and were divided into the control group and experimental group (control group was treated by conventional wound dressing treatment, while the experimental group was treated by VAC wound treatment), the gross appearance of wound surface and healing time were observed and compared between the two groups. The wound tissue water content, tissue blood flow, plasma ET-1 and NO content were detected and compared between the two groups before injury as well as on the 3rd, 7th, and 14th day after injury.Results:Compared with that of the control group, the wound swelling and secretions of experimental group were significantly controlled, the removal of necrotic tissue and growth of granulation tissue both significantly accelerated, the average healing time was significantly shortened(P<0.05), the water content of wound tissue and plasma ET-1 content were all significantly decreased (P <0.05) on the 3rd, 7th and 14th day after injury, while the blood flow of wound tissue and plasma NO content were significantly increased(P<0.05).Conclusion:VAC could play a positive role in the wound healing of rabbits with diabetic ulcers through increasing the plasma NO content and decreasing the plasma ET-1 content, the concrete mechanisms were still needed to be further researched.