辐射生物薄膜促进创面修复的动物和临床实验  

Radiated biological membranes for promoting wound repair in animal and the clinical experiments

作　　者：谢向晨[1] 宋?赫 马勇胜[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院急诊创伤外科,黑龙江省哈尔滨市150001

出　　处：《中国临床康复》2005年第26期141-143,i0007,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨新鲜人羊膜去除绒毛膜干燥后修剪成薄厚各种的单层类型,经塑膜包装后再经γ射线辐射的辐射生物薄膜,在创伤创面修复中对创面的保护和促进愈合作用。方法:①动物实验:2001-03/2002-03在哈尔滨医科大学第一临床医学院急诊创伤实验室完成。选取Wister优质大鼠40只,麻醉后背部脱毛,浸入沸水中8s,致背部烫伤,烫伤面积相当于鼠体表面积的15%～20%,镜检相当于深Ⅱ度创面。每只大鼠的烫伤创面分别贴敷辐射生物薄膜和常规油纱,用纱布间断缝于创缘。术后3d去除敷料,暴露对比分别观察贴敷辐射生物薄膜和油纱后的创面愈合情况。于烫伤后4,6,8,10,12d活杀取材,各8只,对创面愈合情况进行组织学及电镜检查。②临床观察:选取2001-11/2004-11哈尔滨医科大学第一临床医学院急诊创伤外科的130例烫伤患者,共150个创面,其中手术供皮区创面60个,浅Ⅱ度创面50个,深Ⅱ度创面40个。手术供皮区创面:取皮厚度0.5～0.8mm,面积0.5%～4.0%。供皮区取皮后压迫止血,取皮创面对称贴敷辐射生物薄膜和油纱,15d后进行创面的检查换药处置。浅Ⅱ度创面:面积0.25%～3.0%。创面常规清创后,对称贴敷辐射生物薄膜和油纱,2d后进行创面的检查换药处置,对贴敷辐射生物薄膜侧的创面行半暴露疗法,对贴敷油纱侧的创面仍行包扎换药。深Ⅱ度创面:面积0.5%～3.0%。具体方法同浅Ⅱ度创面。如创面干燥,贴敷辐射生物薄膜侧行半暴露疗法,直至创面愈合;如创面渗液较多,给予有孔辐射生物薄膜重新包扎,待渗出停止时再行半暴露疗法。油纱侧检查换药后,仍行创面包扎疗法。结果:动物实验:中途无脱落。创面愈合情况:①大体观察:伤后4,6d贴油纱侧和辐射生物薄膜侧毛发均未长出,炎性水肿逐渐吸收。油纱侧创面伤后12d仍可见灶性小溃疡;而辐射生物薄膜侧创面伤后8d即可见大量毛发生长,伤后10,AIM： To prepare the radiated biological membranes with γ-ray after the fresh human arnnions were divested of chorion, dried, clipped into singlelayer amnions with various thickness and coated with plastic membrane sequentially so as to probe into the effect of them in preventing wounds and promoting the wound repair in the treatment of wounds. METHODS：①Clinical experiment： The clinical experiment was conducted in the Department of Emergency and Wound Surgery, First Affiliated Hospital of Harbin Medical University from March to 2001 March 2002. Forty good-quality Wister rats were depilated on the back after anesthesia, then was dipped into boiling water for 8 seconds to induce scald of back. The scald area was 15% to 20% of rat body surface area, and the scald was deep second-degree wound by microscopic examination. The prepared biological membranes and routine oil gauzes were pressed on all the scale wounds, and the interval gauzes were sutured on the margins of wounds. Three days later, the biological membranes or oil gauzes were removed to expose the wounds, and then the wound healing was compared between the two kinds of dressings. Eight rats were sacrificed to observe wound healing histologically and by electron examination at 4, 6, 8, 10 and 12 days respectively. ②Clinical treatment： Totally 130 scalded patients were selected from the Department of Emergency and Wound Surgery, FiAt Affiliated Hospital of Harbin Medical University between November 2001 and November 2004. There were 150 wounds in the 130 patients including 60 operated donor wounds, 50 superficial second-degree wounds and 40 deep second-degree wounds. For the operated donor wounds： the wounds 0.5 to 0.8 mm in thickness and 0.5% to 4.0% in area were taken. The donor sites were pressed to hemostasia after the skins were taken, and then the radiated biological membranes and oil gauzes matched to the wounds were applied. Fifteen days later, the wounds were examined and managed with dressing change. For the superficial second-degree w

关 键 词：生物敷料 创伤和损伤 修复外科手术 辐射 Γ射线 γ射线辐射 创面修复 生物薄膜 动物实验 临床实验 

分 类 号：R644[医药卫生—外科学] R318.08[医药卫生—临床医学]