封闭负压引流联合局部给氧治疗兔耳缺血性创面的实验研究

目的：观察封闭负压引流联合局部给氧促进兔耳缺血性创面愈合的效果。方法：28只大耳白兔，双耳背各造成直径2．5cm全层皮肤缺损，结扎中央血管神经束及后边缘动静脉，形成缺血创面。56个创面随机分为七组：A组（-50mmHg负压同时给氧，浓度为40％±5％，每日4小时）、B组（持续-50mmHg负压4小时继之局部给氧l小时）、c组（负压治疗4min，停止1min，每日4小时，之后给氧1小时），D组（．50mrnHg负压治疗每日4小时）、E组（-125rnmHg负压治疗每日4小时）、F组（单纯给40％±5％氧l小时）和G组（空白对照）。在创面形成第0、1、3、5、7、10、14、18天拍照，测量创面面积，计算创面愈合率及创面愈合时间；在各时相点切取创面标本，组织学观察创面肉芽、上皮生长、水肿和炎细胞，Ki67免疫组化标记增殖细胞并计算增殖指数，TUNEL法计算凋亡指数。结果：负压给氧组在相同时相点创面愈合率高于单纯负压、氧疗或空白组（P〈0．05），创面肉芽生长快，水肿和炎症轻，细胞增殖指数高于对照组（P〈0．05），而细胞凋亡指数显著低于对照组（P〈0．05）。结论：负压联合局部给氧能显著促进兔耳缺血创面的愈合。

Block Negative Pressure Drainage Combined with Local Oxygen for Ischemic Wound Healing of Rabbit Ears

To investigate the effect of negative pressure therapy （NPT） in combination with Topical oxygen therapy （TOT） on the treatment ofischemic wound in rabbit dorsal ear. Method： There were 56 wounds on both ears of 28 rabbits, and the central neurovascular bundle and the posterior peripheral artery and vein were ligated. They were divided into seven groups： Group A were treated with ONPT for four hours every day; Group B was treated with continuous NPT （-50mmHg） for four hours and an hour TOT; Group C was treated with intermittent NPT （-50mmHg） for four hours and an hour TOT; Group D was treated with NPT （-50mmHg） for four hours; Group E were treated with NPT （-125mmHg） for four hours; Group F was treated with TOT for one hour and group G was treated with conventional dressing change every other day. Take photos of the wounds at the given time point （immediately the wounds were created and the 1^st, 3^th, 5^th, 7^th, 10^th, 14^th, 18^th day after the treatment）, then calculate the areas and the rate of healing with the image analysis. Tissue specimens, collected from the wound, were embedded with paraffin and studied with HE staining to detect the formation of granulation, inflammatory cell infiltration, and the edema. Furthermore, immunohistochemistry for the related antigen of Ki67 was done to estimate the proliferating cells and the Cell Apoptosis Detection Kit was used to assess the apoptosis cells. Then the proliferation and the apoptotic index were calculated. Results： ①the healing rates at the given time point of group A, B and C were higher than that of other groups （P〈0.05）. ②Formation of the granulation in group A, B and C was faster than that of other groups, but the cell infiltration and the edema were less serious than that of group C, D, E and F. ③The proliferation index of group A, B and C is larger than that of other groups, but the apoptotic index in the first three groups is less than that in other ones. Conclusion： NPT in combination with TOT can significantly promote healing of ischemic wound in rabbit dorsal ear.