Objective:To analyze the effect of NPWT in the treatment of elderly patients with deep burn and influence on PDGF,EGF.Methods:Eighty-eight elderly patients with deep burn from Oct.2014 to Oct.2016 in our hospital were selected as the research objects,and randomly divided into control group and research group,44 cases in each group.The control group was treated with conventional debridement immediately and then wound was closed,while research group was debrided after 1 week and then treated with NPWT operation,then close the wound.The clinical effects,granulation tissue,microvessel quantity and the expression of PDGF,EGF were compared.Results:The wound cleaning time and wound healing time of the research group were significantly shorter,and the score of pain was significantly lower (P ＜ 0.01),the hospitalization time of research group was (34.70 ± 9.60) d,which was significantly less than that of control group (46.30 ± 12.50) d (P ＜ 0.01),the clinical effect was better.After treatment,the control group had no obvious wound healing tendency and accompanied by exudation,granulation tissue was little and not fresh,the number of lymphocytes and neutrophils decreased,a few fibroblasts and collagen fibers was visible.The research group had obvious tendency of wound healing,with a large number of fresh granulation tissue,accompanied with a large number of fibroblasts and collagen fibers.The number of lymphocytes and neutrophils of research group were less than those of the control group(P ＜0.01).After treatment,the number of microvessels in two groups were increased,and the number of microvessels in the research group was higher(P＜0.01),the expression of EGF and PDGF in the two groups were significantly increased,and research group were significantly higher (P＜ 0.01).Conclusion:The NPWT can effectively improve the curative effect in treating elderly patients with deep burn wounds,promote the growth of granulation tissue,increase the microvascular number,enhance the expression of PDGF and EGF in the wound tissue,promote cell proliferation,accelerating wound healing.%目的:研究负压治疗对老年深度烧伤创面微血管数量及血小板源性生长因子(PDGF)、上皮生长因子(EGF)表达的影响.方法:以2014-10～2016-10在我院接受治疗的88例老年深度烧伤患者为研究对象,随机分为对照组和研究组,每组44例.对照组患者在人院3d后进行常规清创,1周后进行烧伤创面封闭.研究组患者在入院3d后进行清创和负压伤口治疗(NPWT)手术,1周后进行烧伤创面封闭.比较两组患者的临床疗效、肉芽组织状况、创面组织微血管数量以及PDGF、EGF的表达.结果:研究组的创面清洁时间、创面愈合时间均显著短于对照组,疼痛程度评分显著低于对照组(P＜0.01).研究组患者的住院时间为(34.70±9.60)d,显著短于对照组的(46.30±12.50)d (P＜0.01),且疗效优于对照组.治疗后,对照组的创口无明显愈合倾向并伴有渗液,肉芽组织数量少、不新鲜,淋巴细胞和中性粒细胞数量有所减少,可见部分成纤维细胞以及胶原纤维;研究组创口有明显愈合倾向,肉芽组织数量丰富、饱满新鲜,可见大量成纤维细胞和胶原纤维,淋巴细胞和中性粒细胞数量少于对照组.治疗后两组患者的微血管数量均有所增加,但研究组微血管数量多于对照组.治疗后两组患者的EGF和PDGF的表达均显著升高(P＜0.01),且研究组均显著高于对照组(P＜0.01).结论:采用负压治疗老年深度烧伤创面,可以促进创面肉芽组织生长,增加微血管数量,提升创面组织中PDGF和EGF表达水平,促进细胞分裂增殖,加速创面愈合,提高疗效.
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