大疱性表皮松解症挛缩手与烫伤瘢痕手畸形的形态学对比研究  

Morphological comparison of epidermolysis bullosa contracture hand and scald scarred hand deformity

作　　者：孟宝玺[1] 马富廉[1] 郭腾 王璐[1] 简玉洛[1] Meng Baoxi;Ma Fulian;Guo Teng;Wang Lu;Jian Yuluo(Department of Plastic Surgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院整形外科,450014

出　　处：《中华实验外科杂志》2022年第10期1972-1975,共4页Chinese Journal of Experimental Surgery

摘　　要：目的比较大疱性表皮松解症(EB)挛缩手与烫伤后瘢痕挛缩手的形态学异同。方法将大疱性表皮松解症挛缩手(A组,10例)与烫伤后瘢痕挛缩手(B组,10例)进行大体观察,手部行三维CT成像影像学检查,取挛缩组织行苏木精-伊红(HE)及马松(Masson)组织病理学检测,将大体观察、检测、检查结果比较。组间采用t检验。结果大体观察结果显示:A组各指均出现粘连挛缩,成握拳状,手部大部分功能受限;B组受累手指瘢痕挛缩,手及指功能部分受限。手部三维成像结果显示:两组受累手指都会出现相应的屈曲畸形,关节脱位。HE染色结果显示:A组组织表皮内、表皮与真皮交界均可见裂隙,真皮内胶原纤维均质淡粉红色,玻璃样变;B组组织胶原纤维纵横交错,均质淡粉红色,玻璃样变;Masson染色结果显示:A组胶原纤维密度(++),B组胶原纤维密度(++);阳性面积比值,A组为(70.55±18.06)%,B组为(61.06±8.18)%,差异无统计学意义(t=0.217,P>0.05)。结论大疱表皮松解症挛缩手与烫伤瘢痕挛缩手的临床及病理变化具有相似形态学变化。Objective To compare the morphological similarities and differences between the contractile hand of epidermolysis bullosa(EB)and the post-scald scar contracture hand.Methods The hand of epidermolysis bullosa(group A,10cases)and the scar contracture hand(group B,10cases)after burn were generally observed,and the hand was subjected to three-dimensional CT imaging imaging,and the contracture tissue was taken for hematoxylin and eosin(HE)and Masson histopathological tests,and the general observation,detection and examination results were compared.T-test was used between groups.Results General observation:Adhesion contractures appeared in each finger of group A,which became a clenched fist,and most of the functions of the hand were limited;the injured fingers of group B were scar contractures,and the function of the hand and finger was partially limited.Three-dimensional imaging of the hand shows that both groups of affected fingers will have corresponding flexion deformities and joint dislocations.HE staining:fissures were visible in group A tissue intraepidermal,epidermal and dermal junctions,homogeneous light pink and vitreous in collagen fibers in the dermis;crisscrossed in group B tissue collagen fibers,homogeneous light pink,vitreous;Masson staining:group A collagen fiber density(++),group B collagen fiber density(++);collagen is the dough density of collagen,group A[(70.55±18.06)%],group B is(61.06±8.18)%,t test between groups,the difference was not statistically significant(t=0.217,P>0.05).Conclusion The clinical and pathological changes of the bullous epidermolysis contracture hand and the burn scar hand deformity have the same morphological changes,which provide a basis for the treatment of surgical correction of EB hand contractures.

关 键 词：大疱性表皮松解症 手部瘢痕挛缩 形态学 

分 类 号：R758.59[医药卫生—皮肤病学与性病学] R644[医药卫生—临床医学]