富血小板血浆联合聚乳酸/聚己内酯对小型猪破片伤深部软组织缺损愈合的影响  

Effects of platelet-rich plasma combined with polylactic acid/polycaprolactone on healing of pig deep soft tissue defect caused by fragment injury

作　　者：姚丹 郝岱峰 赵帆 郝秀峰[3] 冯光[2] 褚万立[2] 陈泽群 Yao Dan;Hao Daifeng;Zhao Fan;Hao Xiufeng;Feng Guang;Chu Wanli;Chen Zequn(Medical School of Chinese PLA, Beijing 100853, China;The Third Department of Plastic Surgery and Center of Wound Repair of the Fourth Medical Center of PLA General Hospital, Beijing 100048, China;College of Chemistry of Jilin University, Jilin 130041, China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第四医学中心整形三科暨创面修复中心,北京100048 [3]吉林大学化学学院,吉林130041

出　　处：《中华烧伤杂志》2019年第1期31-39,共9页Chinese Journal of Burns

基　　金：全军后勤科研计划重点项目 (BWS14J049);北京市自然科学基金面上项目 (7182160);国家自然科学基金青年项目 (81601730).

摘　　要：目的探讨富血小板血浆(PRP)联合聚乳酸/聚己内酯(PLA/PCL)对小型猪破片伤深部软组织缺损愈合的影响。方法采用抽签法选取2只雄性巴马小型猪(11~12个月龄,下同)制备PRP。取27只雄性巴马小型猪,于每只猪双侧后肢股部各制造1处高爆弹破片伤深部软组织缺损,按照随机数字表法分为对照组、材料组、PRP+材料组,每组9只。创面清创后,材料组、PRP+材料组猪用PLA/PCL填塞伤道,PRP+材料组同时向伤道内注入2mL激活的PRP,3组猪均缝合皮肤全层封闭创口。记录各组猪手术时间,术后即刻测量伤道长度和体积。术后1、2、4周,每组各处死3只猪,取两侧股部伤道组织及材料组、PRP+材料组猪PLA/PCL,行伤道大体观察和材料降解情况观察。术后2、4周,取各组猪伤道组织,苏木精-伊红染色观察组织形态学变化,免疫组织化学法检测伤道组织转化生长因子β(TGF-β)、血管内皮生长因子(VEGF)蛋白表达和血管生成。取术后1、2、4周伤道组织,实时荧光定量反转录PCR法检测伤道组织TGF-β、VEGFmRNA表达。对数据行析因设计方差分析、单因素方差分析及LSD-t检验。结果(1)3组猪伤道长度及体积比较,差异无统计学意义(F=0.336、0.282,P>0.05)。对照组猪手术时间[(30.9±2.1)min]明显短于材料组[(39.7±2.2)min]和PRP+材料组[(40.0±2.6)min,t=-11.45、-11.88,P<0.01]。(2)对照组、材料组及PRP+材料组猪伤道感染数分别为10、7、5个。对照组猪术后1、2、4周伤道组织均发生感染。材料组及PRP+材料组猪伤道组织均未发生感染,术后1周材料与组织易分离;术后2周部分材料与组织融合,部分材料有降解趋势;术后4周材料与组织完全融合。(3)对照组猪伤道组织术后2周有红细胞及炎性细胞浸润,术后4周仍可见坏死组织及炎性细胞浸润。材料组及PRP+材料组猪伤道组织术后2周有大量红细胞及炎性细胞浸润;术后4周,与材料组比较,PRP+材料组�Objective To investigate the effects of platelet-rich plasma (PRP) combined with polylactic acid/polycaprolactone (PLA/PCL) on healing of mininature pig deep soft tissue defect caused by fragment injury. Methods Two male Bama miniature pigs with 11 to 12 months (the same below) were selected by lottery to prepare PRP. The other twenty-seven male Bama miniature pigs were used to reproduce deep soft tissue defect caused by high-explosive ammunition fragment injury on bilateral posterior femoral region. According to the random number table, 27 pigs were divided into control group, material group, and PRP+material group, with 9 pigs in each group. After debridement, wounds of pigs in material group and PRP+material group were filled with PLA/PCL and PLA/PCL+2 mL activated PRP, respectively. Pigs in each group received suture of full-thickness skin to close the wounds. The operative duration was recorded. The length and volume of wounds of pigs in the above groups were measured immediately after surgery. In 1, 2, and 4 weeks after surgery, 3 pigs in each group were sacrificed to collect femoral wounds tissue on two sides, and PLA/PCL were collected from wounds of pigs in material group and PRP+material group for general observation of wounds tissue and degradation of the material. In 2 and 4 weeks after surgery, wounds tissue was obtained to observe the histological changes by hematoxylin-eosin staining, and expressions of transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF), and angiogenesis were determined by immunohistochemical method. In 1, 2, and 4 weeks after surgery, wounds tissue was collected to determine mRNA expressions of TGF-β and VEGF by real-time quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, one-way analysis of variance, and least significant difference-t test. Results (1) There were no significantly statistical differences in length and volume of the wounds of pigs among the three groups

关 键 词：软组织损伤 富血小板血浆 生物相容性材料 

分 类 号：R62[医药卫生—整形外科]