高压氧能减轻大鼠延迟皮瓣基底部瘢痕粘连和缩短延迟皮瓣血运重建时间  

Hyperbaric oxygen alleviates scar adhesion at the base and shortens the time of revascularization of delayed skin flap in rats

作　　者：胡益高 李高峰[1] Hu Yigao;Li Gaofeng(Department of Laser and Aesthetic Surgery,Hunan Provincial People’s Hospital,First Affiliated Hospital of Hunan Normal University,Changsha 410000,Hunan Province,China)

机构地区：[1]湖南师范大学附属第一医院湖南省人民医院整形激光美容外科,湖南省长沙市410000

出　　处：《中国组织工程研究》2021年第11期1658-1663,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:高压氧能提高皮瓣的存活率,但是关于高压氧治疗能否减少延迟皮瓣与基底的瘢痕粘连,以及是否能够缩短延迟皮瓣血运重建时间尚未有文献报道。目的:观察高压氧治疗后大鼠背部延迟皮瓣与基底部瘢痕组织的变化,寻求一种更安全且需时更短的延迟皮瓣形成方法。方法:健康雄性SD大鼠随机分为2组:高压氧治疗组和对照组,均在SD大鼠背部模拟人耳再造的延迟皮瓣模型,高压氧治疗组在术后置于婴儿高压氧舱行高压氧治疗5 d,记录术前及术后每日皮瓣血流量,术前、术后第1,7,14,21天皮瓣瘢痕组织厚度、Ⅰ/Ⅲ型胶原比值、皮瓣血管数、血管管径、皮瓣血管内皮生长因子表达阳性细胞数。结果与结论:①两组皮瓣血流量均在术后1 d明显降低,之后血流量开始上升。高压氧治疗组术后1,7,14,21 d皮瓣血流量均高于对照组(P<0.05);②高压氧治疗组术后皮下组织水肿较对照组轻,组织炎性细胞浸润较少;③术后21 d高压氧治疗组基底部组织瘢痕粘连厚度小于对照组(P<0.05),Ⅰ/Ⅲ型胶原比值低于对照组(P<0.05);④术后第7,14,21天,高压氧治疗组血管数高于对照组(P<0.05)。两组皮瓣血管管径均在术后1 d最小,术后14 d时最大。高压氧治疗组从术后1 d开始血管管径大于对照组(P<0.05);⑤两组皮瓣血管内皮生长因子阳性细胞数均在术后1 d即开始升高,在术后14 d时到达最大值;高压氧治疗组术后各个时间点血管内皮生长因子阳性细胞数均高于对照组(P<0.05);⑥结果表明,高压氧能减轻大鼠延迟皮瓣与基底部的瘢痕粘连,提高大鼠延迟皮瓣的血流量,其机制可能与促进血管生成有关。BACKGROUND: Hyperbaric oxygen can improve the survival rate of the flap, but whether hyperbaric oxygen therapy can reduce the scar adhesion between the delayed flap and the base, and shorten the time of delayed flap revascularization have not been documented.OBJECTIVE: To observe the changes of the delayed skin flap and the scar tissue at the base on the back of the rat after hyperbaric oxygen therapy, and to seek a safer and more time-saving method of delayed flap formation.METHODS: This experiment simulated the delayed flap model of the human reconstructed ear on the back of Sprague-Dawley rats. Healthy male SpragueDawley rats were randomly divided into two groups: a control group and a hyperbaric oxygen treatment group. In the latter group, the rats were placed in the infant hyperbaric oxygen chamber for hyperbaric oxygen treatment for 5 days after surgery. The blood flow of the flap was recorded preoperatively and daily after surgery. Scar tissue thickness, type Ⅰ/Ⅲ collagen ratio, vascular number, vascular diameter and the number of vascular endothelial growth factor-positive cells in the flap were recorded preoperatively and on the 1st, 7th, 14 th and 21st days postoperatively. RESULTS AND CONCLUSION: The blood flow of the flaps in both groups decreased significantly on the 1st postoperative day, and then began to increase. The blood flow in the hyperbaric oxygen treatment group was significantly higher than that in the control group on the 1 st, 7 th, 14 th and 21 st days postoperatively(P < 0.05). The subcutaneous tissue edema in the hyperbaric oxygen treatment group was slighter than that in the control group, and the tissue inflammatory cell infiltration was less. On the 21st postoperatively day, the thickness of scar tissue adhesion at the base in the hyperbaric oxygen treatment group was smaller than that in the control group(P < 0.05). The ratio of type Ⅰ/Ⅲ collagen in the hyperbaric oxygen treatment group was lower than that in the control group(P < 0.05). On the 7 th, 14th, and 21 st days p

关 键 词：高压氧 延迟皮瓣 耳郭再造 血运重建 因子 瘢痕 大鼠 实验 

分 类 号：R-33[医药卫生—治疗学] R459.6[医药卫生—临床医学]