使用VSD治疗的开放外伤患者血清中炎症因子水平变化及相关性研究

为探讨开放外伤患者在使用VSD治疗后,血清中炎症因子:肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)、白介素-10(IL-10)的变化及影响。采用随机选取2013年1月~2013年10月在我院骨科住院的开放外伤患者,60例使用VSD治疗的患者为研究组,50例常规换药治疗的患者作为对照组。分别于第一次治疗后第0.5、1、2、3、5、7天采集外周静脉血,用酶联免疫吸附法(ELISA)测定血清中TNF-α、IL-6、IL-8、IL-10的含量并对照研究。结果显示,治疗前研究组和对照组静脉血TNF-α、IL-6、IL-8、IL-10含量无显著性差异(P0.05);治疗后两组TNF-α、IL-6、IL-8、IL-10含量均开始升高。治疗后12h开始,研究组的外周静脉血TNF-α含量较对照组明显降低,且具有统计学差异(P0.05);治疗后1 d开始,研究组患者的外周静脉血IL-6、IL-8、IL-10含量较对照组均明显降低,具有统计学差异(P0.05)。由此可知,开放外伤患者使用VSD技术治疗后,可以在很大程度上早期清除创面局部的炎症因子,从而降低激发的炎症放大效应,避免了炎症反应失控和病情恶化,有利于创面的恢复。

Study on Peripheral Blood Inflammatory Factors in Open Trauma Patients Treated with VSD

To explore the level of peripheral blood TNF-α, IL-6, IL-8 and IL-10 in open trauma patients treated with VSD. 110 in-hospital open trauma patients, including 60 treated with VSD and 50 treated with conventional dress changing, were randomly collected from January to October of 2013. The level of TNF-α, IL-6, IL-8, IL -10 in peripheral blood were detected by ELISA at the half, 1st, 2nd, 3rd, 5th and 7 th day after the first treatment. The level of TNF-α, IL-6, IL-8 and IL-10 was no significant difference between the two groups before treatment（P〉0.05）. However, the level of TNF-α, IL-6, IL-8 and IL-10, in both groups, was increased after the treatments. TNF-α in VSD group was lower than that in the control at 12h after treatment （P〈0.05）. IL-6, IL-8, IL-10 in VSD group was lower than that in the control at the 1st day after treatment（P〈0.05）. VSD treatment can eliminated inflammatory factors of wound much earlier than the conventional ways, so as to avoid the inflammatory response and deterioration, which is beneficial to wound healing.