膨体聚四氟乙烯膜阻隔材料预构皮瓣的血管再生  

Vascular regeneration of the prefabricated flap using expanded polytetrafluoroethylene membrane barrier material

作　　者：宋鹏 刘一正 雷震 Song Peng;Liu Yizheng;Lei Zhen(Department of Traumatology,Henan Province Hospital of TCM(The Second Affiliated Hospital of Henan University of Chinese Medicine),Zhengzhou 450002,Henan Province,China;Central Laboratory,Henan Province Hospital of TCM(The Second Affiliated Hospital of Henan University of Chinese Medicine),Zhengzhou 450002,Henan Province,China)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院)创伤外科,河南省郑州市450002 [2]河南省中医院(河南中医药大学第二附属医院)中心实验室,河南省郑州市450002

出　　处：《中国组织工程研究》2023年第12期1914-1919,共6页Chinese Journal of Tissue Engineering Research

基　　金：2019年河南省高等学校重点科研项目(19B320009),项目负责人:宋鹏

摘　　要：背景:尽管预构皮瓣已是修复复合缺损的理想手段,但是皮瓣坏死的风险仍是亟待解决的问题。因此,促进预构皮瓣的再血管化,可提高其存活率并减少并发症。目的:探讨膨体聚四氟乙烯膜阻隔材料对大鼠预构皮瓣血管再生的影响。方法:将30只SD大鼠随机分为3组,每组10只,分别为对照组、硅胶膜组、膨体聚四氟乙烯膜组。硅胶膜组、膨体聚四氟乙烯膜组大鼠采用阻隔延迟方法预制双侧后背任意皮瓣,皮瓣长7.5 cm,宽1.5 cm,分别将硅胶膜、膨体聚四氟乙烯膜植入皮瓣下方;对照组大鼠采用非阻隔延迟方法预制皮瓣,皮瓣下方不垫阻隔物,直接原位缝合。术后大体观察血管再生情况;术后14 d取皮瓣组织进行苏木精-伊红染色、血管内皮生长因子和CD34免疫组化染色;检测皮瓣组织超氧化物歧化酶活性和丙二醛水平。结果与结论:①术后2周皮瓣再次切开,硅胶膜组大鼠部分有轴心血管再生,有1只大鼠硅胶出现卷曲,膨体聚四氟乙烯膜组所有大鼠均可见明显轴心血管;②膨体聚四氟乙烯膜组大鼠的微血管密度值明显高于对照组和硅胶膜组(P<0.05);膨体聚四氟乙烯膜组大鼠的CD34阳性血管数明显多于对照组和硅胶膜组(P<0.05);膨体聚四氟乙烯膜组的血管内皮生长因子蛋白积分吸光度值明显高于对照组和硅胶膜组(P<0.05);③膨体聚四氟乙烯膜组大鼠超氧化物歧化酶活性高于硅胶膜组和对照组(P<0.05),丙二醛水平低于硅胶膜组和对照组(P<0.05);④以膨体聚四氟乙烯膜作为阻隔延迟材料,能促进大鼠预构皮瓣血管生成,减少氧化应激,有助于提高皮瓣成活率。BACKGROUND:Although prefabricated flap is an ideal method to repair composite defects,the risk of flap necrosis is still an urgent problem to be solved.Therefore,promoting the revascularization of prefabricated flap can improve its survival rate and reduce complications.OBJECTIVE:To investigate the effect of expanded polytetrafluoroethylene membrane barrier material on vascular regeneration of prefabricated flap in rats.METHODS:Thirty SD rats were randomly divided into three groups with 10 rats in each group:control group,silica gel membrane group and expanded polytetrafluoroethylene group.In the silica gel membrane group and expanded polytetrafluoroethylene group,bilateral back arbitrary flaps(7.5 cm long and 1.5 cm wide)were prefabricated by the barrier delay method.Silica gel membrane and expanded polytetrafluoroethylene membrane were implanted under the flap.In the control group,the flap was prefabricated with non-barrier delay method,and the flap was directly sutured in situ without barrier under the flap.The vascular regeneration was observed after operation.At 14 days after operation,the flap tissue was stained with hematoxylin and eosin.Immunohistochemistry for vascular endothelial growth factor and CD34 was utilized to detect the activity of superoxide dismutase and the level of malondialdehyde.RESULTS AND CONCLUSION:(1)At 2 weeks after operation,the flap was cut again.In the silica gel membrane group,some rats had axial vascular regeneration and one rat had silicone curl.All rats in the expanded polytetrafluoroethylene group had obvious axial vessels.(2)The microvessel density of expanded polytetrafluoroethylene group was significantly higher than that of control group and silica gel membrane group(P<0.05).The number of CD34 positive vessels in expanded polytetrafluoroethylene group was significantly higher than that in the control and silica gel membrane groups(P<0.05).The integral absorbance of vascular endothelial growth factor protein in the expanded polytetrafluoroethylene group was significantly h

关 键 词：膨体聚四氟乙烯 硅橡胶 预构皮瓣 血管再生 氧化应激 

分 类 号：R446[医药卫生—诊断学] R496[医药卫生—临床医学] R318