自体脂肪源性干细胞联合无菌生物护创膜对慢性创面愈合的影响  

Effect of combined use of autologous adipose-derived stem cells and sterile biological films on chronic wound

作　　者：李明辉[1] 刘洋[1] 陈冲[1] 徐潇[1] 闫俊灵[1] 李梁[1] 王程[1] 赵欣[1] 丁红[1] 汤苏阳[1] 

机构地区：[1]武警总医院再生医学科,北京100039

出　　处：《解放军医学杂志》2016年第12期1025-1030,共6页Medical Journal of Chinese People's Liberation Army

摘　　要：目的评估自体脂肪源性干细胞(ADSCs)联合无菌生物护创膜对慢性创面愈合的作用。方法选取武警总医院收治的60例慢性创面患者,随机分为凡士林油纱组(A组)、无菌生物护创膜组(B组)、ADSCs联合无菌生物护创膜组(C组),每组20例。观察3组创面愈合情况、愈合时间及治疗后7、21、40d时的创面愈合率,治疗前、治疗7d、治疗14d时创面上皮基底层细胞增殖情况及治疗后50d创面上皮化情况,计数治疗前和治疗后7d创面上皮基底层新生微小血管密度(MVD)。结果与A、B组创面愈合情况比较,C组创周炎性反应轻,肉芽组织形成好,创缘上皮爬行速度快,且B组创面愈合情况好于A组。创面愈合时间A组>B组>C组,组间比较差异有统计学意义(P<0.05)。3组治疗后各时间点创面愈合率、创面上皮基底层增殖细胞数、新生微小血管密度比较均为C组优于B组优于A组,差异有统计学意义(P<0.05),治疗后50d创面上皮化情况亦为C组优于B组优于A组。结论自体ADSCs联合无菌生物护创膜可明显改善慢性创面修复细胞的增殖状态,促进创面血管再生,改善创面局部生长环境,加速创面愈合。Objective To analyze and evaluate the effectiveness of combined use of autologous adipose-derived stem cells （ADSCs） and sterile biological films on chronic wound. Methods Sixty patients of chronic wound were selected from the General Hospital of Chinese People＇s Armed Police Forces, and randomly divided into three groups （20 each）： the conventional treatment group （group A）, the sterile biological films group （group B） and ADSCs combined with sterile biological films group （group C）. The wound healing time and healing rate of the 3 groups on 7, 21 and 40d after treatment were observed; The proliferation of the basilar membrane cells of wound epithelium in the 3 groups were observed before and 7, 14d after treatment, and the epithelization on 50d after treatment was also observed. The neonatal microvessel density （MVD） in epidermal basal layer was calculated before and 7 days after treatment. Results On wound healingj the best result was shown in group C, manifested as the minor inflammatory response, the good formation of granulation tissue and faster speed in epithelial growth; and the result was better in group B than in group A. On wound healing timep the result was shown as group A 〉 group B 〉 group Cp and the difference was statistically significant （P〈0.05）. On wound healing rate, cell proliferation and MVD, group C showed the best result in the 3 groups, group B was better than group A, and the differences were statistically significant （P〈0.05）. Conclusion ADSCs combined with sterile biological films in treatment of chronic wound healing may significantly improve the proliferation of repaired cells, promote wound vascular regeneration, improve the local growth environment and accelerate the wound healing.

关 键 词：慢性创面 干细胞 脂肪源性 生物护创膜 伤121愈合 

分 类 号：R622[医药卫生—整形外科]