超脉冲CO_2激光手术创口延迟愈合的组织病理学观察  

The study of wound tissue healing in ultrapulsed carbon dioxide laser incisions

作　　者：杨青华[1] 叶信海[1] 郭涛[1] 王开元[1] 陈熙[1] 周胜杰[1] 

机构地区：[1]温州医学院附属眼视光医院激光整形美容中心,浙江温州325027

出　　处：《眼视光学杂志》2009年第5期382-385,共4页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的观察超脉冲CO2激光手术后创口愈合过程中组织病理和转化生长因子β1(transformin ggrowth factor-β1,TGF-β1)表达特点,探讨其创口延迟愈合的机制,为其临床应用提供指导。方法采用6W超脉冲CO2激光(激光组)及常规手术方法(对照组)对72只大鼠背部皮肤分别致创,随机分成术后9个时相点进行HE染色、TGF-β1免疫组化分析,每个样本独立观察并计数成纤维细胞和TGF-β1阳性细胞。结果①创口愈合时间:对照组于术后第9天愈合,激光组愈合延迟至术后第13天愈合(P<0.01)。②术后5d,激光组成纤维细胞增殖受到抑制,其计数为76.6±7.2,对照组为101.4±20.6(P<0.05);成纤维细胞TGF-β1的分泌受到抑制,分泌时相异常,TGF-β1表达低于对照组,其计数为79.2±12.0,对照组为87.2±18.6(P<0.05)。结论超脉冲CO2激光手术后,由于激光的热损伤导致愈合过程中成纤维细胞增殖抑制和生长因子分泌功能抑制,从而导致激光手术创口的延迟愈合。Objective To compare the histologic appearance of tissue in the healing of ultrapulsed CO2 laser and scalpel incisions in the skin of rats.To investigate whether the ultrapulsed CO2 laser delays wound healing in oculoplastic surgery in order to provide guidance for its clinical application.Methods An ultrapulsed CO2 laser incision（laser group） and a scalpel incision（control group） were made in the skin to form two parallel incisions on each of seventy-two male SD rats.An intensity of 6.0 watts was used for the laser incision.The rats were randomly numbered.Wounds were harvested on a time schedule of 0,1,2,3,5,7,10,15 and 20 days.Each specimen was prepared for staining with haematoxylin and eosin.Fibroblasts and TGF-β1 from every section were counted and evaluated independently.Results ①The average time for closure of the laser incisions was 12.8 days while the parallel scalpel incisions healed in 9.0 days,which was significantly earlier（P〈0.01）.②Histological analysis showed that the granulation tissue of the laser group grew slowly and the proliferation of the fibrob-lasts was inhibited（after 5 days,P〈0.05）.Trauma stimulated the fibroblasts＇ secretion of TGF-β1 with phase characteristics.The secretion of TGF-β1 was inhibited with the laser wound showing an abnormal secretion phase,which had a lower TGF-β1 expression in the intermediate wound healing stage（after 5 days,P〈0.05）.Conclusion The ultrapulsed CO2 laser delayed wound healing due to a dosedependent thermal damage to tissue.This led to a proliferation of fibroblasts and the inhibition of growth factor.

关 键 词：超脉冲CO2激光 愈合 延迟 转化生长因子Β1 成纤维细胞 

分 类 号：R779.63[医药卫生—眼科]