CAJ | 학술논문

背景:皮肤扩张是常用的皮肤软组织增量方法,目前对扩张皮肤的微血管变化特征尚缺乏深入研究.目的:研究扩张皮肤微循环变化特征,确定其稳定血供形成时间.设计:完全随机自身对照的实验研究.地点和材料:实验在山东省潍坊医学院完成,对象为健康成年大白兔20只,平均体质量3 kg,潍坊医学院实验动物中心提供.干预:随机选择一侧兔耳,在兔耳背部皮下埋置扩张器,另一侧相同部位作对照.切口愈合后,以一定时间间隔注水扩张.用微循环显微成像、碱性磷酸酶组织化学染色等形态学研究手段对扩张皮肤微血管进行观测.主要观察指标:扩张皮肤微血管直径、密度、血流速度、流量.结果:扩张组各观测指标均明显高于对照组(P＜0.01).非扩张组的血管密度为(10.8±0.2)×10-3μm2/μm2,扩张4周的是(61.1±2.9)×10-3μm2/μm2,逐渐增加,第5周出现下降;微血管直径扩张第1周为(11.1625±1.0125)μm,3周后为(13.9047±1.4102)μm;血流量第1～3周逐渐增加,此后呈下降趋势;血流速度则在较高水平维持.结论:皮肤扩张后微循环功能增强,早期以血管增生扩张为主,以后逐渐稳定并向正常组织微循环状态转化,其稳定血供的形成至少需要1个月的时间.
배경:피부확장시상용적피부연조직증량방법,목전대확장피부적미혈관변화특정상결핍심입연구.목적:연구확장피부미순배변화특정,학정기은정혈공형성시간.설계:완전수궤자신대조적실험연구.지점화재료:실험재산동성유방의학원완성,대상위건강성년대백토20지,평균체질량3 kg,유방의학원실험동물중심제공.간예:수궤선택일측토이,재토이배부피하매치확장기,령일측상동부위작대조.절구유합후,이일정시간간격주수확장.용미순배현미성상、감성린산매조직화학염색등형태학연구수단대확장피부미혈관진행관측.주요관찰지표:확장피부미혈관직경、밀도、혈류속도、류량.결과:확장조각관측지표균명현고우대조조(P＜0.01).비확장조적혈관밀도위(10.8±0.2)×10-3μm2/μm2,확장4주적시(61.1±2.9)×10-3μm2/μm2,축점증가,제5주출현하강;미혈관직경확장제1주위(11.1625±1.0125)μm,3주후위(13.9047±1.4102)μm;혈류량제1～3주축점증가,차후정하강추세;혈류속도칙재교고수평유지.결론:피부확장후미순배공능증강,조기이혈관증생확장위주,이후축점은정병향정상조직미순배상태전화,기은정혈공적형성지소수요1개월적시간.
BACKGROUND: Skin expansion is a useful method for proliferation of skin soft tissues. Its influence on microcirculation pattern of expanded skin has not been studied thoroughly so far.OBJECTIVE: To study the microcirculation pattern of expanded skin and identify the time for the formation of stable blood supply therein.DESIGN: A completely randomized auto-controlled trial.SETTING and MATERIALS: The experiment was completed in Weifang Medical College. Twenty healthy adult white rabbits with the mean body mass of 3 kg, provided by the Center for Laboratory Animals, were used as experimental animals.INTERVENTIONS: An expander was buried under the skin at the back-side of one ear, the other ear of the same rabbit was used as control. After the incision was recovered, the expander was expanded by infusion of water with equal interval. The microvessel density was measured by microcirculatory imaging system and enzyme histochemical staining.MAIN OUTCOME MEASURES: Microvessel diameter and density, blood volume, and blood velocity were observed.RESULTS: Compared with those of the contrast ear groups, all the recorded values of the experimental ears were increased obviously(all P＜0.01). The value of density was only (10.8±0.2) × 10-3 μ m2/μm2 in the unexpanded skin and that of the expanded skin showed an increase in a time-dependent manner and peaked to reached(61.1 +2.9) × 10-3μm2/μm2 4 weeks after expansion, and then began to decrease since the fifth week. In the expanded skin the microvessel diameter began to increase since 1 week after the expansion with a value of (11.162 5 ± 1.0125) μm and reached(13. 9047+1.4102) μm in the third week. The blood volume reached its highest level in the third week. The blood velocity of the expanded skin remained at a high level since the early stage of experiment.CONCLUSION: The microcirculation function is enhanced by expansion,demonstrated mainly by angiogenesis and expansion of microvessels in the early stage and then the enhanced function become stable and transforms to normal tissue microcirculation. At least one month is needed for the formation of stable blood supply.