CAJ | 학술논문

背景:近年来,同种异体脱细胞真皮基质组织补片已在口腔组织缺损修复中广泛应用,但有关异种脱细胞真皮基质组织补片修复口腔黏膜缺损的研究较少.目的:评价异种脱细胞真皮基质在口腔黏膜组织缺损修复中的效果及生物安全性.方法:选择口腔良、恶性肿瘤手术切除后遗留的黏膜及部分软组织缺损患者71例,男37例,女34例,年龄45(20～70)岁;其中良性肿瘤42例,恶性肿瘤29例.采用异种脱细胞真皮基质组织补片修复口腔软组织浅层缺损.观察生物膜成活情况,颜色、质地,比较组织补片修复无硬组织支撑部位(颊、舌、口底)和有硬组织支撑部位(牙龈、硬腭)的收缩率.结果与结论:71例补片完全成活,未发生坏死、感染等并发症.植入后2周补片成活面积为(98.20±5.20)％,植入后3个月,补片颜色已与周围黏膜相近,大部分患者诉有不同程度的紧张感;植入后6个月补片植入区成功完成了细胞的爬行代替和血管化,生长稳定,无进一步收缩,弹性良好,患者感觉趋于正常.生物膜收缩发生在植入后2周～1个月,植入后3个月后基本稳定,术区组织形态与正常组织相比无明显差异.无硬组织支撑部位(颊、舌、口底)的收缩率较硬组织支撑部位(牙龈、硬腭)收缩率大.说明应用异种脱细胞真皮基质组织补片修复口腔黏膜具有组织相容性好、来源广泛、操作简单等优点,能够起到早期覆盖创面,促进创面愈合,减轻瘢痕生成的作用,可作为口腔黏膜缺损修复的理想材料.
배경:근년래,동충이체탈세포진피기질조직보편이재구강조직결손수복중엄범응용,단유관이충탈세포진피기질조직보편수복구강점막결손적연구교소.목적:평개이충탈세포진피기질재구강점막조직결손수복중적효과급생물안전성.방법:선택구강량、악성종류수술절제후유류적점막급부분연조직결손환자71례,남37례,녀34례,년령45(20～70)세;기중량성종류42례,악성종류29례.채용이충탈세포진피기질조직보편수복구강연조직천층결손.관찰생물막성활정황,안색、질지,비교조직보편수복무경조직지탱부위(협、설、구저)화유경조직지탱부위(아간、경악)적수축솔.결과여결론:71례보편완전성활,미발생배사、감염등병발증.식입후2주보편성활면적위(98.20±5.20)％,식입후3개월,보편안색이여주위점막상근,대부분환자소유불동정도적긴장감;식입후6개월보편식입구성공완성료세포적파행대체화혈관화,생장은정,무진일보수축,탄성량호,환자감각추우정상.생물막수축발생재식입후2주～1개월,식입후3개월후기본은정,술구조직형태여정상조직상비무명현차이.무경조직지탱부위(협、설、구저)적수축솔교경조직지탱부위(아간、경악)수축솔대.설명응용이충탈세포진피기질조직보편수복구강점막구유조직상용성호、래원엄범、조작간단등우점,능구기도조기복개창면,촉진창면유합,감경반흔생성적작용,가작위구강점막결손수복적이상재료.
BACKGROUND:Recently,acellular dermal matrix allograft has been widely used in the repair of oral mucosal defects.But little information is about the heterogeneous acellular dermal matrix (HADM) patch for repair of oral mucosal defects.OBJECTIVE:To investigate the efficacy and biosafety of HADM in the repair of oral mucosal defects.METHODS:In total 71 patients with oral benign or malignant tumors who had oral mucosal or soft tissue defects following tumorectomy were included in this study.These patients comprised 37 males and 34 females,and were averaged 45 years (range,20-70 years old).Of them,42 suffered from benign tumors and 29 from malignant tumors.HADM patches were used for repair of oral mucosal defects.The survival,color,and texture of HADM patches were observed.Shrinkage rate of HADM patches was compared between regions without supports from hard tissues (cheeks,tongue,and mouth floor) and with supports from hard tissues (gingiva,hard palate).RESULTS AND CONCLUSION:All 71 HADM completely survived.No necrosis and infection occurred.At 2 weeks after transplantation,(98.20±5.20) % of patch area survived.At 3 months after transplantation,patches showed similar color to surrounding oral mucosa and most patients had sense of tension to different extents.At 6 months after transplantation,cell creeping substitution and vasculadzation were successfully accomplished in the region of patch transplantation.Patches grew stably,with smooth pink appearance and good elasticity,and no further shdnkage.Patients felt normal.HADM patch shrank primarily at 2 weeks-1 month after transplantation,and tended to be stable at 3 months.There was no significant difference in tissue morphology between surgical region and normal tissue.The HADM shdnkage rate was significantly higher in regions without supports from hard tissues than regions with supports from hard tissues.These findings indicate that HADM patches have advantages in repair of oral mucosal defects including good histocompatibility,wide source,simple manipulation,and able to cover the wound surface in the early state,promote wound surface healing,and reduce scar formation,and can be used as an ideal matedal for repair of oral mucosal defects.