烧伤痂皮组织活细胞提取回植联合人工真皮支架对猪深度烧伤创面愈合的影响  

Effects of extracting and transplanting live cells from burn scab tissue combined with artificial dermal scaffolds on the healing of deep burn wounds in pigs

作　　者：朱敏达 方高丰[1] 马祯一 潘孙峰[1] 王振君[1] ZHU Minda;FANG Gaofeng;Ma Zhenyi;PAN Sunfeng;WANG Zhenjun(Department of Burn Plastic Surgery,Jiaxing Hospital of TCM,Jiaxing 314001,China;不详)

机构地区：[1]嘉兴市中医医院烧伤整形科,314001 [2]嘉兴市中医医院病理科,314001

出　　处：《浙江医学》2025年第6期579-583,589,I0003,共7页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2023KY1225)。

摘　　要：目的探讨烧伤痂皮组织活细胞提取回植联合人工真皮支架对猪深度烧伤创面愈合的影响。方法选取3头雌性巴马小型猪,每头背部在脊柱两侧各建立3个深度烧伤创面,共18个创面。采用左右自身对照,左右创面采用随机数字表法分为A组或B组,A组为人工真皮支架覆盖创面,B组为人工真皮支架联合活细胞覆盖创面。测量术后第7、14、21天的创面愈合率;术后第7、14、21天距创缘内1 cm切取每个创面的全层组织。切取组织进行苏木素-伊红及Masson染色观察病理学改变,免疫组织化学法检测创面α-平滑肌肌动蛋白(α-SMA)、血小板-内皮细胞黏附分子(CD31)、Ki-67染色阳性细胞数。结果(1)术后第7天,A组与B组创面愈合率比较差异无统计学意义(P>0.05);第14、21天,A组均低于B组(均P<0.05)。(2)病理学观察可见术后第7天,两组创面无明显差异;第14天,两组创面均可见大量新生血管及成纤维细胞浸润的未被完全血管化的支架,肉芽组织增生,B组创面明显多于A组,A组炎性细胞数目较B组多;第21天,B组创面较A组更小、更平整。(3)两组创面术后第14天前α-SMA均持续增多,B组创面较A组增长幅度更快;术后第14天后A组创面仍呈现缓慢增长趋势,B组则出现快速下降趋势。(4)术后第7天,A组创面CD31染色阳性的微血管数少于B组(P<0.05)。术后第14天,两组均较第7天呈增长趋势;术后第21天,两组均较术后第14天呈缓慢下降趋势;术后第14、21天,B组均明显多于A组(均P<0.05)。(5)术后两组创面细胞均代偿性增殖,B组创面Ki-67染色阳性细胞数术后整个过程中均高于A组(均P<0.05)。结论烧伤痂皮组织活细胞提取回植联合人工真皮支架治疗可缩短猪深度烧伤创面的愈合时间,增加患处耐磨性,减轻患处瘢痕增生,为深度烧伤创面的治疗提供了新的治疗方法,值得进一步研究。Objective To explore the effects of extracting and transplanting live cells from burn scab tissue combined with artificial dermal scaffolds on the healing of deep burn wounds in pigs.Methods Three female Bama miniature pigs were selected,and three deep burn wounds were established on both sides of the spine of each pig,forming a total of 18 wounds.The wounds on left and right sides were used for self comparison,and the left and right wounds were randomly divided into group A or group B using a random number table method.For group A,the wound was covered with artificial dermal scaffolds,while for group B,the wound was covered with artificial dermal scaffolds combined with live cells.The wound healing rate was measured on postoperative days 7,14,and 21 when the full-thickness tissue was cut from each wound at a distance of 1 cm from the edge.The tissues cut were stained by hematoxylin-eosin and Masson method to GUNobserve pathological changes.Immunohistochemistry was used to detect the number of stained cells positive forα-smooth muscle actin(α-SMA),platelet endothelial adhesion molecule-1(CD31),and nuclear proliferation antigen-67(Ki-67).Results(1)On the 7th day after surgery,there was no statistically significant difference in wound healing rate between group A and group B(P>0.05);On the 14th and 21st days,group A was lower than group B in wound healing rate(both P<0.05).(2)Pathological observation showed no significant differences in the wounds between the two groups on the 7th day after surgery.On the 14th day,both groups of wounds showed a large number of neovascularization and incomplete vascularized scaffolds infiltrated by fibroblasts,with granulation tissue proliferation,the number of newly formed blood vessels and fibroblasts in group B wounds was significantly higher than that in group A;the number of inflammatory cells in group A was higher than that of group B.On the 21st day,the wound size in group B was smaller and smoother than that of group A.(3)The first 14th day after surgery,the levels ofα-SM

关 键 词：烧伤 活细胞 人工真皮支架 深度创面 

分 类 号：R73[医药卫生—肿瘤]