自体表皮细胞悬液与网状自体刃厚皮移植联合治疗深Ⅱ度烧伤创面的临床研究  

Clinical study on the combined application of autologous epidermal cell suspension and meshed autologous split thickness skin graft in the treatment of deep partial thickness burns

作　　者：杨惠忠[1] 徐正鹏[1] 原博[1] 余天漪 刘琰[1] 喜雯婧 乔亮[1] YANG Huizhong;XU Zhenpeng;YUAN Bo;YU Tianyi;LIU Yan;XI Wenjing;QIAO Liang(Department of Burns,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Plastic and Peconstructive Surgery,Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属瑞金医院烧伤整形科,上海市200025 [2]上海交通大学医学院附属第九人民医院整复外科,上海市200011

出　　处：《组织工程与重建外科》2024年第4期411-415,共5页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：中央高校基本科研业务费专项资金资助(YG2022QN048)。

摘　　要：目的探索自体表皮细胞悬液联合网状皮移植用于深Ⅱ度烧伤创面的治疗效果。方法将深Ⅱ度烧伤患者随机分为试验组和对照组,对照组接受刃厚网状皮移植(n=8),试验组以自体表皮细胞悬液联合刃厚网状皮移植进行治疗(n=8)。表皮细胞悬液取自患者自体健康皮肤组织,通过细胞分离器制备获得。统计两组创面愈合时间、治疗后1周的创面愈合率,以及术后8周的瘢痕评分(温哥华量表),并检测制备的细胞悬液中的表皮细胞浓度、活率。结果对照组愈合时间(12.1±0.6)d,试验组愈合时间(10.2±0.3)d;治疗后1周,对照组愈合率为76.97%±10.68%,试验组为94.85%±10.01%;术后8周,瘢痕温哥华评分对照组6.13±3.44,试验组2.92±1.07。各项指标试验组均明显优于对照组(P<0.05)。制备细胞悬液的细胞数量为(1.77±0.11)×10^(6)个细胞/cm2皮肤标本,细胞活率为87.85%±4%。结论本研究初步证实了自体表皮细胞悬液联合网状皮移植用于深Ⅱ度烧伤创面治疗,可促进植皮愈合时间,减少供区面积,并可改善术后的瘢痕增生。Objective To evaluate the effect of autologous epidermal cell suspension combined with mesh skin graft in deep II-degree burn wounds.Methods Patients with deep partial thickness burns were selected as the research subjects and randomly divided into two groups,control group and experimental group,according to the random table method.Control group received split-thickness mesh skin graft(n=8),and experimental group received autologous epidermal cell suspension combined with split-thickness mesh skin graft(n=8).The epidermal cell suspension was prepared from autologous donor skin by cell separator.The wound healing time,wound healing rate on first week after treatment,and scar score(Vancouver scale)on 8th week after surgery were statistically analyzed in the two groups.At the same time,the concentration and viability of epidermal cells in the cell suspension were detected.Results The healing time of experimental group was(10.2±0.3)days,compared with(12.1±0.6)days in control group(P<0.05).The healing rates of control group and experimental group were 76.97%±10.68%vs.94.85%±10.01%(P<0.05)one week after treatment,and the Vancouver scar scores of control group and experimental group were 6.13±3.44 vs.2.92±1.07(P<0.05)at 8 weeks after surgery.The concentration of cell suspension was(1.77±0.11)×10^(6) cells per cm²skin sample,and the cell viability was 87.85%±4%.Conclusion This study preliminarily confirmed that autologous epidermal cell suspension combined with mesh skin transplantation in the treatment of deep partial thickness burns can promote skin grafting healing time,reduce donor area,and improve postoperative scar hyperplasia.

关 键 词：烧伤 植皮 自体皮肤细胞悬液 

分 类 号：R644[医药卫生—外科学]