纤维蛋白胶在犬自体网状皮片移植中的应用

发布时间：2018-05-18 01:03

本文选题：纤维蛋白胶 + 自体网状皮片移植　；参考：《甘肃农业大学》2015年硕士论文

【摘要】：随着我国经济的发展,宠物数量呈现快速增长,由于烧伤、烫伤和车祸等原因造成皮肤缺损的病例数量也逐渐增多;而自体皮肤移植是治疗皮肤缺损的主要手段;在自体皮片移植术中,移植皮片的成活依靠受体床血管的再生,这就要求植皮手术中止血要彻底,术后皮片的固定要稳固;而纤维蛋白胶具有固定作用和良好的止血效果。为此,本实验将纤维蛋白胶应用于犬自体皮片移植术中,以评估纤维蛋白胶对犬自体皮片移植的影响,并从病理组织学及分子生物学角度初步探讨纤维蛋白胶对移植皮片愈合过程中的作用机理,为纤维蛋白胶应用于犬自体网状皮片移植术提供理论依据。本实验首先建立犬前肢皮肤缺损模型,比较犬自体全厚皮片与网状皮片的移植效果,选择一种自体皮片移植成活率较高的自体皮片移植术,然后将纤维蛋白胶应用于自体皮片移植术中作为实验组,以单纯自体皮片移植术为对照组,于术后第3、5、7、14和28d观察记录犬整体状态、移植皮片局部和病理组织学变化,并采用免疫组织化学方法检测移植皮片中4种因子的表达情况,实验结果如下:1.犬自体网状皮片移植术与自体全厚皮片移植术相比,虽然皮片离体时间较长,制备繁琐,但移植皮片局部引流畅通,炎性反应较轻,术后移植皮片成活率较高,移植效果更好。2.实验组术后疼痛反应、移植皮片局部渗血和炎症反应较对照着轻微,成纤维细胞和新生血管数量提高明显,表明纤维蛋白胶可加速移植皮肤的愈合,减少瘢痕形成,愈合后的皮肤解剖和生理机能更接近正常皮肤,可提高移植皮肤的愈合质量。3.bFGF阳性率的表达:术后第3、5、7和14d,实验组和对照组的bFGF阳性率均呈增长趋势,且实验组bFGF阳性率均显著高于对照组(P0.01);术后第28d,实验组bFGF阳性率(18.67±0.88)显著低于对照组(30.67±0.88)(P0.01)。表明纤维蛋白胶可提高移植皮片中bFGF的表达水平,促进成纤维细胞和血管内皮细胞等靶细胞的分裂增殖,加快创伤部位的组织修复和愈合能力。4.VEGF阳性率的表达:术后第3、5、7和14d,实验组和对照组VEGF阳性率均呈增长趋势,且实验组VEGF阳性率均显著高于对照组(P0.01);术后第28d,实验组VEGF阳性率(21.33±1.45)显著低于对照组(28.60±1.20)(P0.01)。表明纤维蛋白胶可提高移植皮片中VEGF的表达水平,促进血管内皮细胞向损伤部位迁移并增殖,诱导新血管的形成,增加创伤修复细胞的数量,加快创伤愈合过程,促进皮肤愈合。5.基因物质P63和整合素β1阳性率的表达:实验组基因物质P63和整合素β1的阳性率都呈先增长后降低的趋势,第14d均为最高(分别为36.00±1.73和23.67±1.20),第28d分别降至32.33±0.88和19.33±1.20;对照组基因物质P63和整合素β1呈增长趋势,第28d最高(分别为26.33±0.33和17.33±0.88);各时间点实验组基因物质P63阳性率均显著高于对照组(P0.01),术后第5、7和14d,实验组整合素β1阳性率均需显著高于对照组(P0.01)。表明纤维蛋白胶可提高移植皮片中基因物质P63和整合素β1的表达水平,使表皮干细胞、血管内皮细胞、巨噬细胞和成纤维细胞等修复细胞在损伤部位快速增殖,缩短炎性反应期,加快皮肤愈合过程。
[Abstract]:With the development of China's economy, the number of pets is increasing rapidly. The number of cases of skin defects caused by burn, scald and car accident is increasing gradually, and autologous skin transplantation is the main method for the treatment of skin defects. In the autologous skin graft, the survival of the skin graft depends on the regeneration of the recipient bed vessel. In this experiment, fibrin glue should be used in canine skin graft to evaluate the effect of fibrin glue on the autologous skin graft of dogs, and from the histopathology and molecular biology angles. The mechanism of fibrin glue on the healing process of skin graft was discussed. It provided a theoretical basis for the use of fibrin glue for autologous reticular skin graft in dogs. First of all, the skin defect model of the canine forelimb was established, and the graft effect of autologous skin autograft and reticular skin graft was compared, and a high survival rate of autologous skin graft was selected. In autologous skin graft, fibrin glue should be used as an experimental group in autologous skin graft, and the autologous skin graft was used as the control group. The whole state of the dog was recorded at 3,5,7,14 and 28d postoperatively. The local and histopathological changes of the skin graft were observed, and 4 factors in the skin graft were detected by immunohistochemistry. The results of the expression were as follows: 1. compared with the autologous skin graft and autologous skin graft, the skin graft has a long time and complicated preparation, but the local drainage of the skin graft is smooth, the inflammatory reaction is lighter, the survival rate of the skin graft is higher after the operation, and the effect of transplantation is better in the.2. experimental group after the operation and the graft skin graft. The number of local blood infiltration and inflammation was less than that of the control. The number of fibroblasts and neovascularization increased obviously. It showed that fibrin glue could accelerate the healing of skin graft and reduce scar formation. The anatomical and physiological function of skin after healing was closer to normal skin. The expression of.3.bFGF positive rate of skin graft skin healing was increased: third after operation. 5,7 and 14d, the positive rate of bFGF in the experimental group and the control group all increased, and the positive rate of bFGF in the experimental group was significantly higher than that in the control group (P0.01). The positive rate of bFGF in the experimental group (18.67 + 0.88) was significantly lower than that of the control group (30.67 + 0.88) (P0.01). The proliferation of target cells, such as cell and vascular endothelial cells, accelerated the expression of.4.VEGF positive rate of tissue repair and healing in the trauma site: the positive rates of VEGF were increased in both 3,5,7 and 14d after operation, and the positive rate of VEGF in the experimental group and the control group was significantly higher than that in the control group (P0.01), and the positive rate of VEGF in the experimental group was 21.33 after the operation (21.33 + 1.45) was significantly lower than that of the control group (28.60 + 1.20) (P0.01). It showed that fibrin glue could improve the expression level of VEGF in the skin graft, promote the migration and proliferation of vascular endothelial cells to the injured part, induce the formation of new blood vessels, increase the number of wound healing cells, accelerate the healing process, and promote the healing of the skin healing.5. gene P63 and integration. Expression of the positive rate of prime beta 1: the positive rate of P63 and integrin beta 1 in the experimental group showed a tendency to increase first, and the highest (36 + 1.73 and 23.67 + 1.20 respectively), and 28d to 32.33 + 0.88 and 19.33 + 1.20, respectively, P63 and integrin beta 1 in the control group, and the highest 28d (26.33 + 0.33, respectively). The positive rate of P63 in the experimental group was significantly higher than that of the control group (P0.01). The positive rate of integrin beta 1 in the experimental group was significantly higher than that of the control group (P0.01). The results showed that the fibrin glue could improve the expression of P63 and integrin beta 1 in the skin graft, and make the epidermal stem cells and vascular endothelium in the skin graft. Cells, macrophages and fibroblasts and other repair cells rapidly proliferate at the injured site, shorten the inflammatory response period, and accelerate the healing process of skin.
【学位授予单位】：甘肃农业大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：S857.1

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