超声造影定量分析负压封闭引流创面血流的影响
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解放军总医院第八医学中心骨科

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北京市自然科学基金(7172211)


Negative Pressure Closed Drainage can Improve Wound Blood Perfusion: proved by Contrast-enhanced Ultrasound
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Orthopedics Surgery Department of 8th Medical Center of General Hospital of PLA

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    摘要:

    摘要 【目的】 采用超声造影定量分析负压封闭引流技术对软组织创面血流灌注的改善情况,并探讨该技术的可能作用机理。【方法】 在深层软组织缺损创面兔模型上,以间断VSD负压吸引为实验组,纱布换药为对照组,采用超声造影技术,定量分析治疗2天后,不同处理组间和组内血流绝对峰值强度、血流增强相对速度显、血流灌注量的变化。【结果】 治疗2天后,VSD组血流绝对峰值增大(P<0.01),而纱布组减小(P<0.01),VSD组的血流绝对峰值强度明显高于无菌纱布组(VSD 13.43±1.53 dB,纱布 3.55±0.7 dB,p<0.01)。VSD组血流达峰时间治疗前后无明显改变(P=0.63),纱布组延长(P<0.01),VSD组的达峰时间短于纱布组(VSD 4.2±0.64s,纱布 5.34±0.53s,p<0.05。VSD组血流灌注量增加(P<0.01),纱布组减小(P<0.01),VSD组的血流灌注量明显高于无菌纱布组(VSD 247.56±53.75 dB×s,纱布 64.18±7.91 dB×s,p<0.01)。【结论】 通过超声造影的定量化分析,证明负压封闭引流技术能够有效改善创面深层软组织的血液灌注,这可能是该技术修复创面的重要机制之一。

    Abstract:

    Abstract 【Objective】Contrast-enhanced ultrasound (CEUS) was used to quantitatively analyze the improvement of blood perfusion in soft tissue wounds treated by vacuum sealing drainage technique, and to explore the possible mechanism of the method. 【Methods】 In the rabbit model of deep soft tissue defect, intermittent VSD negative pressure suction was used as the experimental group, and gauze dressing was applied as the control group. Two days after treatment, the absolute peak intensity of blood flow, the relative velocity of blood flow enhancement and the changes of blood perfusion were quantitatively analyzed by contrast-enhanced ultrasound.【Results】 Two days after treatment, the Absolute Peak Intensity (API) of VSD group increased (P < 0.01), while that of gauze group decreased (P < 0.01). The API of VSD group was significantly higher than that of aseptic gauze group (VSD 13.43 (+1.53 dB), gauze 3.55 (+0.7 dB, P < 0.01); The Time to Peak(TTP) of VSD group did not change significantly before and after treatment (P = 0.63), gauze group prolonged (P < 0.01), and the TTP of VSD group was shorter than gauze group. The blood perfusion in VSD group was increased (P < 0.01) and gauze group decreased (P < 0.01). The blood perfusion in VSD group was significantly higher than that in aseptic gauze group (VSD 247.56 < 53.75 dB×s, gauze 64.18 < 7.91 dB×s, P < 0.01).【Conclusion】 Quantitative analysis of contrast-enhanced ultrasound (CEUS) proved that negative pressure sealing drainage can effectively improve the blood perfusion of deep soft tissue of wound, which may be one of the important mechanisms of this technique in wound repair.

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  • 收稿日期:2019-02-22
  • 最后修改日期:2019-05-10
  • 录用日期:2019-05-20
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