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负压创面治疗对兔创面氧分压变化和血管化的影响

The influence of oxygen partial pressure change and vascularization of rabbit wound through negative pressure wound therapy

摘要:

目的 观察负压封闭引流(VSD)技术对兔创面模型局部氧分压(PtO2)变化和新生毛细血管(NBC)形成的影响.方法 建立12只兔创面模型,实施VSD手术(负压组),于7d内各时间点用组织氧分压测量仪监测创面PtO2变化;以实时荧光PCR法检测创面低氧诱导因子1α(HIF-1α)mRNA的表达;以ELISA法检测创面血管内皮生长因子(VEGF)的含量;通过光镜观察血管内皮细胞(VEC)和NBC并计数.设立常规换药实验兔(常规组)进行对照.结果 建模后负压组PtO2较常规组显著降低(t=-99.780~ -5.305,P<0.01).自30 min起负压组的HIF-1αmRNA表达(30 min,1、6、12 h分别为3.11±0.07、3.68±0.26、4.16±0.13和3.91±0.26)和VEGF含量(pg/L) (30 min,1、6、12 h分别为103.3±2.4、134.2±9.0、167.8±3.8和232.1±9.5)较常规组显著升高(t=13.038~80.208,P<0.01).1d后两组HIF-1α mRNA表达和VEGF含量均开始下调,但负压组仍持续高于常规组(P<0.05),同时负压组的创面VEC(2.47±0.45 ~4.70±0.38)和NBC计数(1.33±0.49~4.33±0.68)较常规组升高(t=-0.670 ~ 16.500,P<0.05).结论 VSD技术可通过降低创面Pt02、上调HIF-1α mRNA的表达,促进VEGF的合成,增加VEC的分化和NBC的形成,有利于创面愈合.

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abstracts:

Objective To investigate the effect of vacuum sealing drainage (VSD) on variation of oxygen partial pressure ( PtO2 ) and vascularization.Methods The 12 cases of rabbit's wound models were undergoing the VSD ( vacuum group,n =6) or conventional therapy ( conventional group,n =6).Variation of PtO2 was measured by oxygen partial pressure admeasuring apparatus,expression of hypoxia inducible factor 1α (HIF-1α) mRNA was measured by real-time fluorescent quantitative PCR,content of vascular endothelial growth factor (VEGF) was measured by ELISA after tissue homogenate in 7 days.Vascular endothelial cell (VEC) and new blood capillary (NBC) of hematoxylin-eosin slice of tissue were counted by using light microscope.Results Average value of PtO2 of vacuum group was significant lower than conventional group (t=-99.780 to -5.305,P<0.01).Expression of HIF-1α (30 minutes,1,6,12 hours were 3.11 ±0.07,3.68 ±0.26,4.16 ±0.13 and 3.91 ±0.26 respectively) and content of VEGF (30 minutes,1,6,12 hours were 103.3 ±2.4,134.2 ±9.0,167.8 ±3.8 and 232.1 ±9.5 respectively)of vacuum group were increased after 30 minutes and significant lower than conventional group ( t =13.038-80.208,P <0.01 ),and both of them were reduced after 24 hours (P <0.05 ).Counting numbers of VEC (2.47 ± 0.45 to 4.70 ± 0.38 ) and NBC ( 1.33 ± 0.49 to 4.33 ± 0.68 ) of vacuum group were increased at the same time-point and significant higher than conventional group ( t =- 0.670 to 16.500,P < 0.05 ).Conclusions PtO2 of wound surface could be reduced significantly by VSD.Expression of HIF-1α and content of VEGF were increased by VSD for enhancing differentiated state of VEC and construction of NBC,which were better for vascularization and wound healing.

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