中华整形外科杂志
中華整形外科雜誌
중화정형외과잡지
Chinese Journal of Plastic Surgery
2015年
5期
365-369
,共5页
吴建龙%侯瑞兴%周广良%巨积辉
吳建龍%侯瑞興%週廣良%巨積輝
오건룡%후서흥%주엄량%거적휘
外科皮瓣%雌二醇%缺血再灌注%组织形态学
外科皮瓣%雌二醇%缺血再灌註%組織形態學
외과피판%자이순%결혈재관주%조직형태학
Surgical flap%Estradiol%Ischemia reperfusion%Histomorphology
目的 探索雌二醇对大鼠皮瓣缺血再灌注损伤组织形态学的影响及其可能机制.方法 取12～ 14周龄雄性健康Wistar大鼠48只,随机分为对照组(Ⅰ组)、缺血再灌注组(Ⅱ组)、生理盐水组(Ⅲ组)、雌二醇组(Ⅳ组),每组12只大鼠,制作皮瓣缺血再灌注损伤模型.术后7d,测定皮瓣存活率;检测腹壁浅静脉血清中性粒细胞浓度;切取皮瓣远端组织,在光镜、电镜下观察组织形态学变化.结果 术后7d,皮瓣存活率Ⅳ组显著高于Ⅱ、Ⅲ组(P＜0.05).Ⅳ组腹壁浅静脉血清中性粒细胞浓度明显低于Ⅱ、Ⅲ组(P＜0.05).光镜下观察:Ⅰ组皮瓣组织结构正常,无明显变化;Ⅱ、Ⅲ组皮瓣皮下疏松结缔组织层水肿明显,有大量中性粒细胞浸润;Ⅳ组皮瓣组织水肿程度轻,组织内炎性反应明显轻于Ⅱ、Ⅲ组.电镜下观察:Ⅰ组皮瓣中性粒细胞结构完整,胶原纤维排列规则;Ⅱ、Ⅲ组皮瓣胶原纤维排列紊乱,中性粒细胞内部分细胞器结构消失,有溶酶体形成Ⅳ组皮瓣内部分中性粒细胞胞质肿胀,有少量凋亡小体形成,但细胞结构完整.结论 雌二醇能够抑制皮瓣内中性粒细胞介导的炎症级联反应,减轻缺血再灌注损伤皮瓣中组织结构的病理改变,提高皮瓣存活率.
目的 探索雌二醇對大鼠皮瓣缺血再灌註損傷組織形態學的影響及其可能機製.方法 取12～ 14週齡雄性健康Wistar大鼠48隻,隨機分為對照組(Ⅰ組)、缺血再灌註組(Ⅱ組)、生理鹽水組(Ⅲ組)、雌二醇組(Ⅳ組),每組12隻大鼠,製作皮瓣缺血再灌註損傷模型.術後7d,測定皮瓣存活率;檢測腹壁淺靜脈血清中性粒細胞濃度;切取皮瓣遠耑組織,在光鏡、電鏡下觀察組織形態學變化.結果 術後7d,皮瓣存活率Ⅳ組顯著高于Ⅱ、Ⅲ組(P＜0.05).Ⅳ組腹壁淺靜脈血清中性粒細胞濃度明顯低于Ⅱ、Ⅲ組(P＜0.05).光鏡下觀察:Ⅰ組皮瓣組織結構正常,無明顯變化;Ⅱ、Ⅲ組皮瓣皮下疏鬆結締組織層水腫明顯,有大量中性粒細胞浸潤;Ⅳ組皮瓣組織水腫程度輕,組織內炎性反應明顯輕于Ⅱ、Ⅲ組.電鏡下觀察:Ⅰ組皮瓣中性粒細胞結構完整,膠原纖維排列規則;Ⅱ、Ⅲ組皮瓣膠原纖維排列紊亂,中性粒細胞內部分細胞器結構消失,有溶酶體形成Ⅳ組皮瓣內部分中性粒細胞胞質腫脹,有少量凋亡小體形成,但細胞結構完整.結論 雌二醇能夠抑製皮瓣內中性粒細胞介導的炎癥級聯反應,減輕缺血再灌註損傷皮瓣中組織結構的病理改變,提高皮瓣存活率.
목적 탐색자이순대대서피판결혈재관주손상조직형태학적영향급기가능궤제.방법 취12～ 14주령웅성건강Wistar대서48지,수궤분위대조조(Ⅰ조)、결혈재관주조(Ⅱ조)、생리염수조(Ⅲ조)、자이순조(Ⅳ조),매조12지대서,제작피판결혈재관주손상모형.술후7d,측정피판존활솔;검측복벽천정맥혈청중성립세포농도;절취피판원단조직,재광경、전경하관찰조직형태학변화.결과 술후7d,피판존활솔Ⅳ조현저고우Ⅱ、Ⅲ조(P＜0.05).Ⅳ조복벽천정맥혈청중성립세포농도명현저우Ⅱ、Ⅲ조(P＜0.05).광경하관찰:Ⅰ조피판조직결구정상,무명현변화;Ⅱ、Ⅲ조피판피하소송결체조직층수종명현,유대량중성립세포침윤;Ⅳ조피판조직수종정도경,조직내염성반응명현경우Ⅱ、Ⅲ조.전경하관찰:Ⅰ조피판중성립세포결구완정,효원섬유배렬규칙;Ⅱ、Ⅲ조피판효원섬유배렬문란,중성립세포내부분세포기결구소실,유용매체형성Ⅳ조피판내부분중성립세포포질종창,유소량조망소체형성,단세포결구완정.결론 자이순능구억제피판내중성립세포개도적염증급련반응,감경결혈재관주손상피판중조직결구적병리개변,제고피판존활솔.
Objective To study the influence of estradiol on histomorphology of skin flaps with ischemia reperfusion injury.Methods 48 adult male Wistar rats aged 12-14 weeks old,were randomly divided into control group (group Ⅰ),ischemia-reperfusion group (group Ⅱ),saline group (group Ⅲ),estradiol group (group Ⅳ).Superficial epigastric artery axial flap,3 cm × 6 cm in size,was made in the left lower quadrant abdominal of each rat.Flap model with ischemia-reperfusion injury was established by using the nondestructive micro vascular clamp to clamp the superficial epigastric artery.The general condition of the flap was observed after operation.At 7 days after operation,the survival rate of the flap was detected,the flaps were harvested to receive histology and ultrastructural observation.The neutrophils level of the superficial epigastric vein were tested.Results 7 days after operation,the survival rate of the flap in groupⅣ was significantly higher than that in group Ⅱ,Ⅲ (P ＜ 0.05).The neutrophils level in group Ⅳ was lower than that in group Ⅱ,Ⅲ (P ＜ 0.05).The histological observation showed that the degree of tissue swelling and inflammatory exudation in groupⅣ was more slight than that in group Ⅱ,Ⅲ.Presence of high neutrophils density were observed in group Ⅱ,Ⅲ,while slight inflammation and necrosis were observed in groupⅣ.In group Ⅰ,collagen fibers in flap are regularly arranged with no significant necrosis.Oganelles structure disappeared and apoptotic bodies were shown in group Ⅱ and group Ⅲ,even the lysosome could be seen in the cell.Collagen fibers in flap are regularly arranged with slight swelling and no obvious ultrastructural necrocytosis was seen in the cell of group Ⅳ.Conclusion The estradiol can significantly increase flap survival rate by inhibiting neutrophils infiltration and improving the pathological changes of organization structure in flap.
