中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
CHINESE JOURNAL OF PLASTIC SURGERY
2011年
1期
31-35
,共5页
段晨旺%鲍世威%徐刚%姜海%李森恺
段晨旺%鮑世威%徐剛%薑海%李森愷
단신왕%포세위%서강%강해%리삼개
A型肉毒毒素%肌皮瓣%软组织扩张术%小型猪
A型肉毒毒素%肌皮瓣%軟組織擴張術%小型豬
A형육독독소%기피판%연조직확장술%소형저
Botulinum toxin A%M yocutaneous flap%Skin soft tissue expansion%Minipigs
目的 探讨A型肉毒毒素对小型猪扩张肌皮瓣的组织学影响.方法 小型猪7只,在左、右两侧腰肋部对称区域分别作面积为10 cm×6 cm的文身区,将A型肉毒毒素96 U随机注射于一侧文身区皮肌层,每点注射4 U(0.1 ml),注射间距2 cm(肉毒毒素组),另一侧注射等量生理盐水,作为对照.3 d后于两侧腰肋部对称部位分别植入200 ml扩张器1枚.完成扩张后,在两组扩张肌皮瓣对应部位取材进行HE及Masson染色,观察扩张肌皮瓣组织结构变化,对比两侧扩张肌皮瓣的厚度及组织学改变.结果 肉毒毒素组肌层、包膜层、真皮层平均厚度分别为(275.74±28.93)μm、(468.03±34.28)μm、(1990.79±102.10)μm,生理盐水组分别为(409.13±44.63)μm、(626.55±44.05)μm、(2508.44±70.71)μm,肉毒毒素组各指标明显低于生理盐水组,两组比较差异均有统计学意义(P＜0.01).Masson染色显示肉毒毒素组扩张器包膜胶原平均灰度为185.38±9.56,明显高于生理盐水组的120.77±10.31,两组比较差异有统计学意义(P＜0.01).光镜下HE染色显示肉毒毒素组肌肉明显萎缩,肌纤维横截面面积减少,生理盐水组皮肌肌纤维大致正常;电镜下见肉毒毒素组肌细胞明暗带模糊,Z线弯曲,生理盐水组皮肌肌细胞明暗带排列整齐,Z线清晰.结论 使用A型肉毒毒素辅助肌皮瓣扩张,可使肌肉萎缩,肌皮瓣变薄,包膜中胶原纤维含量减少.
目的 探討A型肉毒毒素對小型豬擴張肌皮瓣的組織學影響.方法 小型豬7隻,在左、右兩側腰肋部對稱區域分彆作麵積為10 cm×6 cm的文身區,將A型肉毒毒素96 U隨機註射于一側文身區皮肌層,每點註射4 U(0.1 ml),註射間距2 cm(肉毒毒素組),另一側註射等量生理鹽水,作為對照.3 d後于兩側腰肋部對稱部位分彆植入200 ml擴張器1枚.完成擴張後,在兩組擴張肌皮瓣對應部位取材進行HE及Masson染色,觀察擴張肌皮瓣組織結構變化,對比兩側擴張肌皮瓣的厚度及組織學改變.結果 肉毒毒素組肌層、包膜層、真皮層平均厚度分彆為(275.74±28.93)μm、(468.03±34.28)μm、(1990.79±102.10)μm,生理鹽水組分彆為(409.13±44.63)μm、(626.55±44.05)μm、(2508.44±70.71)μm,肉毒毒素組各指標明顯低于生理鹽水組,兩組比較差異均有統計學意義(P＜0.01).Masson染色顯示肉毒毒素組擴張器包膜膠原平均灰度為185.38±9.56,明顯高于生理鹽水組的120.77±10.31,兩組比較差異有統計學意義(P＜0.01).光鏡下HE染色顯示肉毒毒素組肌肉明顯萎縮,肌纖維橫截麵麵積減少,生理鹽水組皮肌肌纖維大緻正常;電鏡下見肉毒毒素組肌細胞明暗帶模糊,Z線彎麯,生理鹽水組皮肌肌細胞明暗帶排列整齊,Z線清晰.結論 使用A型肉毒毒素輔助肌皮瓣擴張,可使肌肉萎縮,肌皮瓣變薄,包膜中膠原纖維含量減少.
목적 탐토A형육독독소대소형저확장기피판적조직학영향.방법 소형저7지,재좌、우량측요륵부대칭구역분별작면적위10 cm×6 cm적문신구,장A형육독독소96 U수궤주사우일측문신구피기층,매점주사4 U(0.1 ml),주사간거2 cm(육독독소조),령일측주사등량생리염수,작위대조.3 d후우량측요륵부대칭부위분별식입200 ml확장기1매.완성확장후,재량조확장기피판대응부위취재진행HE급Masson염색,관찰확장기피판조직결구변화,대비량측확장기피판적후도급조직학개변.결과 육독독소조기층、포막층、진피층평균후도분별위(275.74±28.93)μm、(468.03±34.28)μm、(1990.79±102.10)μm,생리염수조분별위(409.13±44.63)μm、(626.55±44.05)μm、(2508.44±70.71)μm,육독독소조각지표명현저우생리염수조,량조비교차이균유통계학의의(P＜0.01).Masson염색현시육독독소조확장기포막효원평균회도위185.38±9.56,명현고우생리염수조적120.77±10.31,량조비교차이유통계학의의(P＜0.01).광경하HE염색현시육독독소조기육명현위축,기섬유횡절면면적감소,생리염수조피기기섬유대치정상;전경하견육독독소조기세포명암대모호,Z선만곡,생리염수조피기기세포명암대배렬정제,Z선청석.결론 사용A형육독독소보조기피판확장,가사기육위축,기피판변박,포막중효원섬유함량감소.
Objective To investigate the histologic effect of botulinum toxin type A (Botox A )injection on myocutaneous flap expansion in minipigs model. Methods Seven minipigs were included in this study. Two symmetric tatoo area, 10 cm× 6 cm in size, were seclected on the bilateral flank of the pigs. The Botox A was injected into one tatoo area randomly, 4 U every point, 2 cm apart, with a total dose of 96 U. The same dose of sterile normal saline (0.9%) was injected in the same fashion on the opposite side as control. 3 days after injection , two 200 ml expanders were inserted beneath the cutaneous muscle at the tatto area. After complete expansion of 200 ml, the specimens were drawn from both groups symmetrically and were stained by means of HE and Masson. The histologic changes of myocutaneous flap were compared. Thickness of each layer in myocutaneous flap was measured in histological section. Results The thickness of cutaneous muscle, capsule, dermis were ( 275.74 ± 28.93 ) μm、 (468.03 ± 34.28 )μm 、(1990.79 ± 102.10) μm in Botox group, and (409.13 ± 44.63) μm、(626.55 ±44.05) μm、( 2508.44 ± 70.71 ) μm in saline group, respectively, show a significant difference between the two groups (P ＜0.01 ). The Masson stained slice showed that collagen average gray of capsule in Botox group was 185.38 ±9.56, which was significantly higher than that in the saline group( 120.77 ± 10.31, P ＜0.01 ).Light microscope ( HE stained sections ) showed that muscle in Botox group was significantly atrophy and cross-section of muscle fiber decreased. The muscle fiber in saline group was generally normal. It was observed through transmission electron microscope that the light and dark band of muscle cell became fuzzy and the Z line bending in Botox group. The light and dark band in saline group arranged neatly, the Z line was clear. Conclusions Application of Botox A in myocutaneous flap expansion can make the muscle atrophy and reduce the content of collagen in capsule layer, makeing the myocutaneous flap thinner which is suitable for reconstruction in face and neck.
