自体富血小板血浆对游离皮瓣修复兔软组织缺损的影响  

Effects of autologous platelet-rich plasma in the repair of soft tissue defects of rabbits with free flap

作　　者：李洋 郑健生[1] 王彪[1] 薛文娇 Li Yang;Zheng Jiansheng;Wang Biao;Xue Wenjiao(Department of Burns and Plastic Surgery,the 909th Hospital of PLA (Affiliated Southeast Hospital of Xiamen University),Zhangzhou 363000,China)

机构地区：[1]解放军联勤保障部队第九〇九医院(厦门大学附属东南医院)烧伤整形科,漳州363000

出　　处：《中华烧伤杂志》2019年第9期683-689,共7页Chinese Journal of Burns

基　　金：南京军区医学科技创新课题(11MA079);福建省自然科学基金(2019J01143).

摘　　要：目的探讨自体富血小板血浆(PRP)对游离皮瓣修复兔软组织缺损的影响。方法取30只6个月龄、雌雄不拘新西兰大白兔,心脏采血后Aghaloo法制备PRP,于每只兔耳制作5 cm×3 cm的游离皮瓣模型。采用随机数字表法选择每只兔一侧兔耳作为PRP组,另一侧兔耳作为生理盐水组。PRP组兔耳皮瓣基底均匀涂抹1.0 mL自体PRP,生理盐水组涂抹等量生理盐水,皮瓣原位回植。分别于术后2、3、5、7、14 d,每组取6只兔,观察并记录兔耳皮瓣成活情况;取皮瓣组织,行苏木精-伊红染色观察皮瓣基底组织形态;采用免疫荧光法检测皮瓣基底组织的CD31和α平滑肌肌动蛋白(α-SMA)表达。另取1只同等实验条件下不制备皮瓣的6个月龄雄性新西兰大白兔,分别采集全血和制备PRP,行血小板计数及采用双抗体夹心酶联免疫吸附测定法检测血管内皮生长因子(VEGF)和转化生长因子β(TGF-β)含量。对数据行析因设计方差分析、配对样本t检验及Bonferroni校正。结果(1)术后2 d,PRP组兔创面皮瓣颜色彤红,与基底组织贴合良好;生理盐水组兔创面皮瓣颜色暗红,与基底组织贴合不良。术后3 d,PRP组兔创面皮瓣颜色红润,与基底组织贴合紧密;生理盐水组兔创面皮瓣散在斑状暗红,与基底组织贴合一般。术后5 d,PRP组兔创面皮瓣淡红,与基底组织贴合紧密,皮瓣已成活;生理盐水组兔创面皮瓣与基底组织贴合紧密,皮瓣颜色红润。术后7 d,PRP组兔创面皮瓣表面覆盖中量兔毛,皮瓣颜色与周围皮肤颜色接近;生理盐水组兔创面皮瓣与基底贴合一般,表面仅有少量绒毛覆盖。术后14 d,PRP组兔创面愈合良好,生理盐水组仍有小创面尚未愈合。(2)术后2 d,2组兔创面皮瓣均有炎性细胞浸润。术后3 d,PRP组兔创面皮瓣可见新生微血管,间质出血少;生理盐水组兔创面皮瓣新生微血管少。术后5 d,生理盐水组兔创面皮瓣中量炎性细胞浸润,新生微血管�Objective To explore the effects of autologous platelet-rich plasma (PRP) in the repair of soft tissue defects of rabbits with free flap. Methods Thirty 6-month-old New Zealand white rabbits, male and female unlimited, were used to harvest blood from the heart. PRP was prepared by Aghaloo method, then free flap model with size of 5 cm×3 cm was reproduced on each ear of the rabbit. According to the random number table, one ear of each rabbit was recruited to PRP group, and the other ear was recruited to normal saline group. The base of flap on rabbit ear in PRP group was evenly spread with 1.0 mL autologous PRP, and equivalent volume of normal saline was applied to that in normal saline group. Then, the flap was replanted in situ. On post surgery day (PSD) 2, 3, 5, 7, and 14, 6 rabbits in each group were taken. The survival of flap was observed and recorded. The morphology of the basal tissue of flap was observed by hematoxylin-eosin staining. The expressions of CD31 and α smooth muscle actin (α-SMA) in the basal tissue of flap were detected by immunofluorescence method. Another 6-month-old male New Zealand white rabbit without making flap under the same experimental conditions was used for harvesting whole blood and preparing PRP. Then blood platelet count in whole blood and PRP was determined, and the content of vascular endothelial growth factor (VEGF) and transforming growth factor β(TGF-β) was detected by double-antibody sandwich enzyme-linked immunosorbent assay. Data were processed with analysis of variance of factorial design, paired sample t test, and Bonferroni correction. Results (1) On PSD 2, the flaps of wounds of rabbits in PRP group were reddish and adhered well to the basal tissue;the flaps of wounds of rabbits in normal saline group were dark red and poorly attached to the basal tissue. On PSD 3, the flaps of wounds of rabbits in PRP group were ruddy and closely adhered to the basal tissue;the flaps of wounds of rabbits in normal saline group were scattered in the plaque-like dark red and gen

关 键 词：富血小板血浆 外科皮瓣 伤口愈合 微血管密度 

分 类 号：R622[医药卫生—整形外科]