文章摘要
吴康康1 赵建辉1 徐伟华2 胡世劼3 王大雷1 易成刚1 夏炜1 韩岩1△ 郭树忠1△.负压封闭引流术治疗犬胸壁全层缺损的实验研究[J].,2012,12(11):2022-2026
负压封闭引流术治疗犬胸壁全层缺损的实验研究
Research of Full-Thickness Chest Wall Defects in Dogs Treated byVacuum Sealing Drainage
  
DOI:
中文关键词: 负压封闭引流  胸壁缺损  气胸  创面愈合
英文关键词: Vacuum sealing drainage(VSD)  Chest wall defects  Pneumothorax  Wound healing
基金项目:全军医药卫生科研基金(08G116)
作者单位
吴康康1 赵建辉1 徐伟华2 胡世劼3 王大雷1 易成刚1 夏炜1 韩岩1△ 郭树忠1△ 第四军医大学西京医院全军整形外科研究所 
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中文摘要:
      目的:探讨不同负压大小下的封闭负压引流术(vacuum sealing drainage, VSD)在治疗犬胸壁全层缺损创面愈合的效果。方 法:25 只健康成年犬的右胸壁制作3cm×4cm 大小的全层缺损,随机分为5 组,所有胸壁缺损处安装一次性封闭式负压吸引器, 手动抽吸负压排出胸膜腔气体产生负压,致伤24 小时后复查CT 观察气胸情况;然后按照压力表显示调节负压至 60kpa,40kpa,20kpa,10kpa,0kpa 吸引胸壁,比较五组1d,3d,5d 的伤口液体引流量,胸膜闭合时间;5d 时伤口取材做HE 染色及 CD34 免疫组化染色观察伤口愈合情况。结果:在60kpa 和40kpa 负压吸引下,1 天引流液体量最多,分别为77.6±6.62 ml,77.8± 4.97 ml;胸膜闭合最快,分别为3.2±1.30 天,3.6±0.55 天,但是60kpa 组有一只犬血气分析显示为Ⅰ型呼吸衰竭;HE 染色和 CD34 免疫组化染色显示各组均有肉芽组织增生及血管新生,且40kpa 和60kpa 负压组肉芽组织和血管密度明显多于其他组,二 者之间无明显差异。结论:封闭负压吸引器对胸壁全层缺损创面有明显治疗作用,并且在40kpa 负压下治疗效果最好而且安全。
英文摘要:
      Objective: To investigate the application of vacuum sealing drainage ( VSD) on the full-thickness chest wall defects of dogs. Methods: 25 dogs with 3cm×4cm chest wall defected were randomly divided into 5 groups. All the defects were connected to the disposable-VSD devices. Gas was pumped out of pleural cavity by VSD with the help of vacuum gauge. 24 hours later, CT scan were applied to check the pneumothorax existed. The groups were divided by different subpressure: 60kpa, 40kpa, 20kpa, 10kpa, 0kpa. In each group, the drainage of the wound and time of pleura closing were measured at 1st, 3rd and 5th day after surgery. At 5th day, tissues were drawn to observe by HE and immunohistology staining. Results: The drainage of subpressure 60kpa (77.6±6.62ml) and 40kpa (77.8± 4.97ml) group were more than others at the first day, and the closing time of pleura of 60kpa (3.2±1.30days) and 40kpa (3.6±0.55days) group were faster. However, blood gas analysis manifested typeⅠrespiratory failure in group 60kpa. HE staining showed there was granulation tissue and immunohistology staining showed CD34positive. No difference existed between group 60kpa and 40kpa, but neovascularization in the two groups is much more than that in the other three groups. Conclusion: VSD is effective to treat chest wall defects, and the drainage of 60kpa and 40kpa group are much more than others, and 40kpa group can achieve the best result and be safer.
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