负压封闭引流术对胫骨骨折术后感染患者炎性因子及微循环的影响

作者单位:110044 沈阳,武警辽宁省总队医院骨科

 胫骨骨折;负压封闭引流术;感染;炎性因子;微循环

Effect of Vacuum Sealing Drainage on Inflammatory Factors and Microcirculation in Patients with Postoperative Infection of Tibial Fracture
YAO Jinchi, YANG Chunlu, HAN Zhongxiao, SUO Ji, GAO Hongwei, WANG Zhaoning, LU Sai

(Department of Orthopaedics, Liaoning Provincial Army Hospital, Shenyang 110044, Liaoning Province, China)

 Tibial Fracture; Vacuum Sealing Drainage; Infection; Inflammatory Factors; Microcirculation

DOI: 10.3969/j.issn.1672-7185.2020.02.022

备注

 目的  从炎性因子和微循环的角度的探讨负压封闭引流技术( V S D)对胫骨骨折术后创面感染的改善作用。方法  选择武警辽宁省总队医院2016年1月—2018年12月收治的胫骨骨折术后出现创面感染的患者81例,随机分为对照组40例和观察组41例。对照组对感染创面采用常规处理措施,观察组采用V SD方法进行治疗,比较两组治疗后炎性因子和微循环改善情况。结果  治疗后,观察组细胞间黏附因子-1、可溶性血管细胞黏附因子-1水平低于对照组,而核因子 κB水平高于对照组,差异有统计学意义( P<0.05);观察组流态积分、管襻积分、襻周积分和总积分均低于对照组,差异有统计学意义( P<0.05)。结论  V SD技术可以有效改善胫骨骨折术后创面感染患者的炎症和微循环状态,有利于促进创面恢复。
 Objective  From the perspective of inflammatory factors and microcirculation, we aimed to explore the effect of vacuum sealing drainage (VSD) on wound infection after tibial fracture operation. Methods  A total of 81 patients with wound infection after operation of tibial fracture admitted in our hospital from January 2016 to December 2018 were randomly divided into control group (40 cases) and observation group (41 cases). In the control group, the infected wounds were treated with routine treatment, and in the observation group, VSD was used for infected wounds. The improvement of inflammatory factors and microcirculation were compared. Results  After treatment, the level of sICAM-1 and sVCAM-1 in the observation group was significantly lower than those in the control group, while the level of NF-κB was significantly higher than that in the control group (P<0.05). The flow integral, loop integral, loop integral and total integral of the observation group were significantly lower than those of the control group (P<0.05). Conclusion  VSD can effectively improve the inflammation and microcirculation of patients with infection of tibial fracture after operation, which is beneficial to the recovery of wound.