胫骨横向搬移系统在糖尿病足溃疡实验研究中的应用  

Application of tibial transverse migration system in experimental research on diabetic foot ulcers

作　　者：周海东 罗昌泰 谢康麒 周俊秀 韦积华[2] 梁吉运 韦凤旭 赵瑞良 罗富强 李载永 王玮 罗东 陈禄昌 ZHOU Hai-dong;LUO Chang-tai;XIE Kang-qi;ZHOU Jun-xiu;WEI Ji-hua;LIANG Ji-yun;WEI Feng-xu;ZHAO Rui-liang;LUO Fu-qiang;LI Zai-yong;WANG Wei;LUO Dong;CHEN Lu-chang(Graduate School,Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;不详)

机构地区：[1]右江民族医学院研究生院,广西百色533000 [2]右江民族医学院附属医院运动医学科,广西百色533000 [3]百色市妇幼保健院药学科,广西百色533000

出　　处：《广东医学》2023年第8期947-954,共8页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(82260887);广西医疗卫生适宜技术开发与推广应用项目(S201917);2022年右江民族医学院研究生创新计划项目(YZCXJH2022004);2023年右江民族医学院研究生创新计划项目(YXCXJH2023004)。

摘　　要：目的观察Ilizarov术对糖尿病足溃疡创面修复的作用。方法将60只新西兰兔按随机数字表法分为正常组、急性组和实验组。正常组不作任何处理;急性组做全层足背皮肤缺损创面,创面常规消毒、换药处理;实验组静脉注射四氧嘧啶100 mg/kg制作糖尿病兔模型。将实验组随机分为模型组、VEGF组和横搬组。急性组和模型组只作换药处理;VEGF组予重组牛碱性生长因子凝胶涂擦;横搬组每天外搬移0.5 mm,7 d后反方向搬移回位。分别于10、14 d取材检测,计算创面愈合率,对比各组间创面愈合情况。HE、Masson染色检测实验兔创面组织的病理形态学变化。结果第10天,与模型组相比,急性组愈合较快;与急性组相比,横搬组、VEGF组愈合明显加快。第14天,与模型组相比,急性组愈合较快;与急性组相比,横搬组、VEGF组愈合明显加快。HE、Masson染色发现模型组皮肤组织紊乱、炎细胞浸润明显,胶原蛋白沉积少;与模型组相比,其余各组组织结构较规则、炎细胞浸润减轻,胶原沉积明显增多,以横搬组最明显。结论此研究表明,Ilizarov术可抑制炎细胞浸润、促进糖尿病足创面愈合。Objective To observe the efficacy of Ilizarov surgery on diabetic foot ulcer.Methods Sixty New Zealand rabbits were randomly divided into a normal group,an acute group,and an experimental group.The normal group received no treatment,the acute group underwent full-thickness skin defects on the dorsum of the foot,and the wounds were conventionally disinfected and dressed.The experimental group was intravenously injected with streptozotocin at 100 mg/kg to establish a diabetic rabbit model.The experimental group was further randomized into the model group,VEGF group,and transverse migration group.The acute group and model group only received dressing changes,the VEGF group received topical application of recombinant bovine basic fibroblast growth factor gel,and the transverse migration group had daily outward migration of 0.5 mm,followed by returning to the original position after 7 days.Tissue samples were collected and assessed at 10 and 14 days to calculate the wound healing rate and compare wound healing among the groups.Histological changes in the wound tissues of experimental rabbits were examined using HE and Masson staining.Results On Day 10,compared to the model group,the acute group showed faster healing;compared to the acute group,the transverse migration group and VEGF group exhibited significantly accelerated healing.On Day 14,compared to the model group,the acute group showed faster healing;compared to the acute group,the transverse migration group and VEGF group demonstrated significantly accelerated healing.HE and Masson staining revealed disordered skin tissue and significant inflammatory cell infiltration in the model group,with less collagen deposition.In contrast,the tissue structure was more regular,inflammatory cell infiltration was reduced,and collagen deposition was significantly increased in the other groups,particularly in the transverse migration group.Conclusion This study indicates that the Ilizarov technique can suppress inflammatory cell infiltration and promote diabetic foot wound hea

关 键 词：Ilizarov胫骨横搬术 慢性创面 糖尿病足 瘢痕 

分 类 号：R608[医药卫生—外科学] R578.2[医药卫生—临床医学]