富血小板纤维蛋白修复大鼠骨外露创面的实验研究  

Experimental study of platelet-rich-fibrin repairing wounds with exposed bone of rats

作　　者：张虹[1] 雷忱 王彪[1] Zhang Hong;Lei Chen;Wang Biao(Department of Plastic and Cosmetic Surgery,the First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院整形美容外科,福州350005

出　　处：《中华整形外科杂志》2020年第3期313-320,共8页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金(81801931);福建省卫生教育联合攻关计划项目(2019-WJ-09);福建省科技厅自然基金卫生联合基金(2018J01154,2018J01163);福建省医学创新课题资助项目(2018-CX-26)。

摘　　要：目的探讨富血小板纤维蛋白(PRF)治疗大鼠骨外露创面的疗效。方法取10~12周龄,250~300 g的雄性SD大鼠24只,应用随机数字表法将其分为3组,每组8只。将所有SD大鼠前头盖骨区域1.5 cm×1.5 cm皮肤全层切除及并去除颅骨表面的骨膜。PRF组创面覆盖PRF;脂肪移植组创面覆盖等量脂肪颗粒;对照组创面覆盖等量生理盐水。分别于第4、7和11天对创面换药。使用Image J软件对骨外露面积进行量化评估。应用HE染色和马松三色染色评估创面新生血管和胶原沉积情况。酶联免疫吸附实验检测创面肉芽组织生长因子水平。组间比较采用随机资料单因素方差分析。结果术后第4天时,PRF组大鼠骨外露比例为57.99%±11.29%;脂肪移植组骨外露比例为45.92%±9.55%;对照组骨外露比例为77.73%±5.57%。第7天时,PRF组大鼠骨外露比例为4.29%±2.28%;脂肪移植组骨外露比例为29.52%±6.33%;对照组骨外露比例为36.90%±8.43%。第11天时,仅PRF组的骨外露创面完全被肉芽组织覆盖,脂肪移植组及对照组均存在不同程度的骨外露,分别为10.15%±1.49%和21.69%±2.40%。PRF组在各时间点创面骨外露面积均显著低于对照组,差异具有统计学意义(P<0.01)。在第7天和第11天时,PRF组的骨外露比例显著低于脂肪移植组,但是在第4天时,脂肪移植组的骨外露比例却低于PRF组,差异均具有统计学意义(P<0.001)。第11天时,HE染色结果显示PRF组的新生微血管密度为(10.37%±0.49%)显著高于脂肪移植组(4.86%±0.83%)和对照组(2.91%±0.31%)(P<0.05),马松三色染色结果显示PRF组的胶原纤维最丰富。酶联免疫吸附实验结果提示第11天时PRF组的生长因子水平均明显升高,与脂肪移植组和对照组比较,差异均具有统计学意义(P<0.05)。结论PRF作为一种取材方便的治疗手段,对修复创面具有良好的疗效,可加快骨外露创面愈合。Objective To investigate the effect of Platelet-rich-fibrin(PRF)in repairing wounds with exposed bone of rats.Methods 24 male Sprague-Dawley rats(250-300 g)were divided into 3 groups randomly using random number table,8 rats in each group.A 1.5 cm×1.5 cm full-thickness wound was excised over the posterior scalp area and all the periosteum overlying the skull was removed.The wounds in the PRF group were covered with PRF clot;the wounds in the fat transplantation group were covered with the same volume of fat granules;the wounds in the control group were covered with the same volume of normal saline.The wound dressing was changed on day 4,7,and 11,respectively.Quantitative assessment of bone exposure area was performed using Image J software.HE staining and Masson staining were used to evaluate the neovascularization and collagen deposition in wounds.The expression level of growth factors in granulation tissue in wounds was measured by Elisa.Results On day 4,the bone exposure rate was 57.99%±11.29%in the PRF group,45.92%±9.55%in the fat transplantation group;and 77.73%±5.57%in the control group.On day 7,the bone exposure rates of the three groups were 4.29%±2.28%,29.52%±6.33%and 36.90%±8.43%,respectively.While on day 11,only the exposed wounds in the PRF group were completely covered by granulation tissue.There were different degrees of bone exposure in the fat transplantation group and the control group,about 10.15%±1.49%and 21.69%±2.40%,respectively.The exposed area of wound bone in the PRF group was significantly smaller than that in the control group at each time point(P<0.01).On day 7 and day 11,the bone exposure ratio of the PRF group was significantly lower than that of the fat transplantation group,while on day 4,the bone exposure ratio of the fat transplantation group was significantly lower than that of the PRF group(P<0.001).HE results showed that the neovascularization density in the PRF group(10.37%±0.49%)was significantly higher than that in the fat transplantation group(4.86%±0.83%)and the

关 键 词：富血小板纤维蛋白 创面愈合 脂肪移植 肉芽组织 

分 类 号：R6[医药卫生—外科学]