慢性创面治疗新进展
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摘要
当今不断增多的慢性创面已成为患者个人、社会、医疗的沉重负担。本文就慢性创面的发病原因、发生机制、治疗阶段性目标及其创新性治疗手段等诸方面进行了回顾总结,旨在为创面处理工作提供更有益的参考。
At present,the increasing number of chronic wounds has become a heavy burden on patients,the same as society and medical system. This article reviews from some aspects,such as the etiology,mechanism and treatment of chronic wounds milestones and its innovative treatments,which gives a summary and aims to provide more useful references for the treatment of chronic wounds in clinic.
At present,the increasing number of chronic wounds has become a heavy burden on patients,the same as society and medical system. This article reviews from some aspects,such as the etiology,mechanism and treatment of chronic wounds milestones and its innovative treatments,which gives a summary and aims to provide more useful references for the treatment of chronic wounds in clinic.
引文
[1]Menke NB,Ward KR,Witten TM,et al.Impaired wound healing[J].Clin Dermatol,2007,25(1):19-25.
[2]Clinton A,Carter T.Chronic Wound Biofilms:Pathogenesis and Potential Therapies[J].Lab Med,2015,46(4):277-284.
[3]石冰,谭家祺,陈绍宗,等.慢性创面的病理生理以及治疗[J].组织工程与重建外科杂志,2006,2(1):58-60.
[4]付小兵.进一步重视体表慢性难愈合创面发生机制与防治研究[J].中华创伤杂志,2004,20(8):449-451.
[5]蒋国群.近5年慢性难愈创面住院患者临床特点调查分析[D].衡阳:南华大学,2014.
[6]刘晖,佘文莉,黄海玲,等.165例慢性创面住院患者临床特点调查及分析[J].广东医学,2010,31(9):1183-1185.
[7]刘光维.压疮防治进展[J].护理研究,2005,19(23):2082-2084.
[8]Penhallow K.A review of studies that examine the impact of infection on the normal wound-healing process[J].J Wound Care,2005,14(3):123-126.
[9]Saito T,Izumi K,Shiomi A,et al.Zoledronic acid impairs reepithelialization through down-regulation of integrinαvβ6 and transforming growth factor beta signalling in a three-dimensional in vitro wound healing model[J].Int J Oral Maxillofac Surg,2014,43(3):373-380.
[10]Diegelmann RF.Cellular and biochemical aspects of normal and abnormal wound healing:an overview[J].J Urol,1997,157(1):298-302.
[11]Xu J,Clark RA,Parks WC.p38 mitogen-activated kinase is a bidirectional regulator of human fibroblast collagenase-1 induction by three-dimensional collagen lattices[J].Biochem J,2001,355(Pt 2):437-447.
[12]陈健霞,荣新洲,樊桂成,等.不同浓度腐胺对人皮肤成纤维细胞增殖、迁移和凋亡的影响[J].南方医科大学学报,2015,5(5):758-762.
[13]樊桂成,荣新洲.多胺代谢在临床研究中的意义及进展[J/CD].中华损伤与修复杂志(电子版),2011,6(6):1007-1011.
[14]陈健霞,荣新洲,陈沅然.不同浓度腐胺对人肝细胞增殖及凋亡的影响[J/CD].中华损伤与修复杂志(电子版),2014,9(4):377-381.
[15]荣新洲.慢性创面修复中的损伤控制外科[J/CD].中华损伤与修复杂志(电子版),2013,8(6):566-569.
[16]弓辰,吕开阳,王光毅,等.水动力清创系统在烧伤创面中的应用[J].中华烧伤杂志,2015,31(6):470-472.
[17]李梦芸,毛远桂,郭光华,等.水动力清创系统在各类烧伤创面清创手术中的应用[J].中华烧伤杂志,2016,32(9):574-576.
[18]Van Damme H,Limet R.The diabetic foot[J].Rev Med Liège,2005,60(5/6):516-525.
[19]Armstrong DG,Lavery LA,Diabetic Foot Study Consortium.Negative pressure wound therapy after partial diabetic foot amputation:a multicentre,randomised controlled trial[J].Lancet,2006,366(9498):1704-1710.
[20]Ilizarov GA.The tension-stress effect on the genesis and growth of tissues.Part I.The influence of stability of fixation and softtissue preservation[J].Clin Orthop Relat Res,1989(238):249-281.
[21]秦泗河.Ilizarov技术概述[J].中华骨科杂志,2006,26(9):642-645.
[22]曲龙,王爱林,汤福刚.胫骨横向搬移血管再生术治疗血栓闭塞性脉管炎[J].中华医学杂志,2001,81(10):49-51.
[23]付小兵,王亚平,常国友,等.碱性成纤维细胞生长因子加速小型猪背部创伤修复的实验研究[J].中华创伤杂志,1995,11(3):134.
[24]赵林,王川江,刘畅,等.数字式多功能外伤清洗机对创面清洗效果的评价[J].重庆医学,2014,43(29):3910-3911.
[25]陈海清,周桂东,庞玲英,等.慢性创面应用超声波清创机清创的效果观察[J].护理学报,2012,19(12):46-47.
[26]Chen C,Hou WH,Chan ES,et al.Phototherapy for treating pressure ulcers[J].Cochrane Database Syst Rev,2014(7):CD009224.
[27]张丽,付小兵.光学疗法治疗慢性难愈合创面的研究进展[J].感染、炎症、修复,2015,16(4):251-254.
[28]Schumann H,Calow T,Weckesser S,et al.Water-filtered infrared A for the treatment of chronic venous stasis ulcers of the lower legs at home:a randomized controlled blinded study[J].Br J Dermatol,2011,165(3):541-551.
[29]高春华,高超.高压氧对皮肤慢性溃疡的促愈作用[J].中国临床康复,2003,7(6):1054-1054.
[30]Liu ZJ,Velazquez OC.Hyperoxia,endothelial progenitor cell mobilization,and diabetic wound healing[J].Antioxid Redox Signal,2008,10(11):1869-1882.
[31]付小兵,王正国.现代高新技术与创伤修复[M].北京:人民军医出版社,2002:280-287.
[32]朱建辛,张耀明.重组人表皮细胞生长因子在慢性溃疡创面中的应用[J].中国修复重建外科杂志,2002,16(1):42-43.
[33]Akita S,Yoshimoto H,Akino K,et al.Early experiences with stem cells in treating chronic wounds[J].Clin Plast Surg,2012,39(3):281-292.
[34]Fromm-Dornieden C,Koenen P.Adipose derived stem cells(ASC)in wound healing:Recent results in vitro and in vivo[J].OA Molecular&Cell Biology,2013,1(1):8.
[35]Yamasaki K,Edington HD,Mcclosky C,et al.Reversal of impaired wound repair in i NOS-deficient mice by topical adenoviral-mediated i NOS gene transfer.[J].J Clin Invest,1998,101(5):967-971.
[36]Sun L,Xu L,Chang H,et al.Transfection with a FGF c DNA improves wound healing[J].J Invest Dermatol,1997,108(3):313-318.
[37]孙永华,李迟,王春元,等.脱细胞异体真皮与自体薄皮片移植的研究与应用[J].中华整形烧伤外科杂志,1998,14(5):370-373.
[38]Johnson PE,Kernahan DA,Bauer BS.Dermal and epidermal response to soft-tissue expansion in the pig[J].Plast Reconstr Surg,1988,81(3):390-397.
[39]Knight KR,Mccann JJ,Vanderkolk CA,et al.The redistribution of collagen in expanded pig skin[J].Br J Plast Surg,1990,43(5):565-570.
[40]代佑果,寸英丽.皮肤替代物研究及应用进展[J].中国美容整形外科杂志,2008,19(2):132-135.
[41]Ehrlich HP.Understanding experimental biology of skin equivalent:from laboratory to clinical use in patients with burns and chronic wounds.[J].Am J Surg,2004,187(5A):29S-33S.
[2]Clinton A,Carter T.Chronic Wound Biofilms:Pathogenesis and Potential Therapies[J].Lab Med,2015,46(4):277-284.
[3]石冰,谭家祺,陈绍宗,等.慢性创面的病理生理以及治疗[J].组织工程与重建外科杂志,2006,2(1):58-60.
[4]付小兵.进一步重视体表慢性难愈合创面发生机制与防治研究[J].中华创伤杂志,2004,20(8):449-451.
[5]蒋国群.近5年慢性难愈创面住院患者临床特点调查分析[D].衡阳:南华大学,2014.
[6]刘晖,佘文莉,黄海玲,等.165例慢性创面住院患者临床特点调查及分析[J].广东医学,2010,31(9):1183-1185.
[7]刘光维.压疮防治进展[J].护理研究,2005,19(23):2082-2084.
[8]Penhallow K.A review of studies that examine the impact of infection on the normal wound-healing process[J].J Wound Care,2005,14(3):123-126.
[9]Saito T,Izumi K,Shiomi A,et al.Zoledronic acid impairs reepithelialization through down-regulation of integrinαvβ6 and transforming growth factor beta signalling in a three-dimensional in vitro wound healing model[J].Int J Oral Maxillofac Surg,2014,43(3):373-380.
[10]Diegelmann RF.Cellular and biochemical aspects of normal and abnormal wound healing:an overview[J].J Urol,1997,157(1):298-302.
[11]Xu J,Clark RA,Parks WC.p38 mitogen-activated kinase is a bidirectional regulator of human fibroblast collagenase-1 induction by three-dimensional collagen lattices[J].Biochem J,2001,355(Pt 2):437-447.
[12]陈健霞,荣新洲,樊桂成,等.不同浓度腐胺对人皮肤成纤维细胞增殖、迁移和凋亡的影响[J].南方医科大学学报,2015,5(5):758-762.
[13]樊桂成,荣新洲.多胺代谢在临床研究中的意义及进展[J/CD].中华损伤与修复杂志(电子版),2011,6(6):1007-1011.
[14]陈健霞,荣新洲,陈沅然.不同浓度腐胺对人肝细胞增殖及凋亡的影响[J/CD].中华损伤与修复杂志(电子版),2014,9(4):377-381.
[15]荣新洲.慢性创面修复中的损伤控制外科[J/CD].中华损伤与修复杂志(电子版),2013,8(6):566-569.
[16]弓辰,吕开阳,王光毅,等.水动力清创系统在烧伤创面中的应用[J].中华烧伤杂志,2015,31(6):470-472.
[17]李梦芸,毛远桂,郭光华,等.水动力清创系统在各类烧伤创面清创手术中的应用[J].中华烧伤杂志,2016,32(9):574-576.
[18]Van Damme H,Limet R.The diabetic foot[J].Rev Med Liège,2005,60(5/6):516-525.
[19]Armstrong DG,Lavery LA,Diabetic Foot Study Consortium.Negative pressure wound therapy after partial diabetic foot amputation:a multicentre,randomised controlled trial[J].Lancet,2006,366(9498):1704-1710.
[20]Ilizarov GA.The tension-stress effect on the genesis and growth of tissues.Part I.The influence of stability of fixation and softtissue preservation[J].Clin Orthop Relat Res,1989(238):249-281.
[21]秦泗河.Ilizarov技术概述[J].中华骨科杂志,2006,26(9):642-645.
[22]曲龙,王爱林,汤福刚.胫骨横向搬移血管再生术治疗血栓闭塞性脉管炎[J].中华医学杂志,2001,81(10):49-51.
[23]付小兵,王亚平,常国友,等.碱性成纤维细胞生长因子加速小型猪背部创伤修复的实验研究[J].中华创伤杂志,1995,11(3):134.
[24]赵林,王川江,刘畅,等.数字式多功能外伤清洗机对创面清洗效果的评价[J].重庆医学,2014,43(29):3910-3911.
[25]陈海清,周桂东,庞玲英,等.慢性创面应用超声波清创机清创的效果观察[J].护理学报,2012,19(12):46-47.
[26]Chen C,Hou WH,Chan ES,et al.Phototherapy for treating pressure ulcers[J].Cochrane Database Syst Rev,2014(7):CD009224.
[27]张丽,付小兵.光学疗法治疗慢性难愈合创面的研究进展[J].感染、炎症、修复,2015,16(4):251-254.
[28]Schumann H,Calow T,Weckesser S,et al.Water-filtered infrared A for the treatment of chronic venous stasis ulcers of the lower legs at home:a randomized controlled blinded study[J].Br J Dermatol,2011,165(3):541-551.
[29]高春华,高超.高压氧对皮肤慢性溃疡的促愈作用[J].中国临床康复,2003,7(6):1054-1054.
[30]Liu ZJ,Velazquez OC.Hyperoxia,endothelial progenitor cell mobilization,and diabetic wound healing[J].Antioxid Redox Signal,2008,10(11):1869-1882.
[31]付小兵,王正国.现代高新技术与创伤修复[M].北京:人民军医出版社,2002:280-287.
[32]朱建辛,张耀明.重组人表皮细胞生长因子在慢性溃疡创面中的应用[J].中国修复重建外科杂志,2002,16(1):42-43.
[33]Akita S,Yoshimoto H,Akino K,et al.Early experiences with stem cells in treating chronic wounds[J].Clin Plast Surg,2012,39(3):281-292.
[34]Fromm-Dornieden C,Koenen P.Adipose derived stem cells(ASC)in wound healing:Recent results in vitro and in vivo[J].OA Molecular&Cell Biology,2013,1(1):8.
[35]Yamasaki K,Edington HD,Mcclosky C,et al.Reversal of impaired wound repair in i NOS-deficient mice by topical adenoviral-mediated i NOS gene transfer.[J].J Clin Invest,1998,101(5):967-971.
[36]Sun L,Xu L,Chang H,et al.Transfection with a FGF c DNA improves wound healing[J].J Invest Dermatol,1997,108(3):313-318.
[37]孙永华,李迟,王春元,等.脱细胞异体真皮与自体薄皮片移植的研究与应用[J].中华整形烧伤外科杂志,1998,14(5):370-373.
[38]Johnson PE,Kernahan DA,Bauer BS.Dermal and epidermal response to soft-tissue expansion in the pig[J].Plast Reconstr Surg,1988,81(3):390-397.
[39]Knight KR,Mccann JJ,Vanderkolk CA,et al.The redistribution of collagen in expanded pig skin[J].Br J Plast Surg,1990,43(5):565-570.
[40]代佑果,寸英丽.皮肤替代物研究及应用进展[J].中国美容整形外科杂志,2008,19(2):132-135.
[41]Ehrlich HP.Understanding experimental biology of skin equivalent:from laboratory to clinical use in patients with burns and chronic wounds.[J].Am J Surg,2004,187(5A):29S-33S.