负压封闭引流术应用于胸腔内引流的效果

摘要

目的 探讨负压封闭引流应用于胸膜腔内引流的效果.方法 取新西兰大白兔20只建立气胸动物模型后,随机将其分为负压封闭引流组(实验组)及胸腔闭式引流组(对照组),每组10只,术后第4天行X线片检查,并取胸腔引流液行生化检测及碱性成纤维细胞生长因子(bFGF)含量测定,术后第8天取兔脏层胸膜组织作光镜观察并计算其厚度及成纤维细胞数.结果 每组各有9只兔完成实验,术后X线片检查,气胸均消失.实验组术后1、4 d的胸腔积液引流量分别为(15.7±6.2)mL和(18.8±7.0)mL,均明显多于对照组的(6.5±3.5)mL和(7.0±4.9)mL(P<0.05);实验组和对照组术后4 d胸液中蛋白质含量分别为(59.4±7.1)g/L和(45.8±3.8)g/L,bFGF含量分别为(982.4±182.3)pg/mL和(690.5±114.2)pg/mL,实验组均显著高于对照组(P<0.05);对照组术后4 d胸液中白细胞数和葡萄糖浓度分别为(66.0±24.3)×109·L-1和(4.3±0.6)mmoL/L,均显著高于实验组的(43.6±22.9)×109·L-1和(2.6±0.1)mmoL/L(P<0.05);实验组和对照组脏层胸膜厚度分别为(364.3±18.7)μm和(168.1±46.5)μm,成纤维细胞数分别为(183.8±31.1)·mm-2和(59.5±25.4)·mm-2,实验组均明显高于对照组(P<0.01).结论 负压封闭引流术应用于胸腔内可明显促进家兔胸膜组织成纤维细胞增生,进而促进脏、壁层胸膜组织粘连,闭合胸膜腔.%Objective To study the effects of the vacuum sealing drainage ( VSD ) appliep into pleural cavity drainage. Methods Twenty rabbits were randomly divided into 2 groups: VSD group and control group. The chest radiography was carried out 1 and 4 days after surgery, while the biochemical test and bFGF of pleural effusion was also performed. The visceral pleura tissues were collected for light microscopic observation for assessment of the thickness and fi-broblast cell count. Results Experiment was completed in 9 rabbits out of each group completed the experiment. Pneu-mothorax was disappeared in all rabbits after surgery. On 1st and 4th day, the pleural effusion were significantly more in VSD group than those in control group [ ( 15. 7 ±6. 2 )mL is ( 6. 5 ±3. 5 )mL, and ( 18. 8 ±7. 0 )mL is ( 7. 0 ±4. 9 )mL, respectively, P<0. 05 ]; so were pleural protein content and bFGF on 4th day [ ( 59.4 ±7. 1 )g/L is (45. 8 ±3. 8 )g/L, and ( 982. 4 ± 182. 3 )pg/mL vs ( 690. 5 ± 114. 2 )pg/mL, respectively, P <0. 05 ]. The leukocyte count and glucose level in VSD group on the 4th day were significantly lower than those in control group [ ( 43. 6 ±22. 9 ) ×10 · L-1 vs ( 66. 0 ± 24. 3 ) ×109 · L-1 , and ( 2. 6 ±0. 1 )mmol/L is ( 4. 3 ±0. 6 )mmol/L, respectively, P <0. 05 ]. In the VSD group and the control group, the significantly improvement in visceral pleural thickness and elevation of fibroblast count were revealed in VSD group, when comparing with those in control group [ ( 364. 3 ± 18. 7 )μm vs ( 168. 1 ±46. 5 )μm, and ( 183. 8 ± 31. 1 ) · mm-2 vs( 59. 5 ±25. 4 ) · mm-2 , respectively, P <0. 05 ]. Conclusion The application of VSD in pleural cavity can obviously promote the pleura fibroblast proliferation, visceral and parietal pleura tissue adhesion, thus accelerate the close of pleural cavity.