低浓度尼古丁对大鼠硬腭软组织缺损愈合的影响

发布时间：2018-05-16 00:09

本文选题：尼古丁 + 软组织缺损　；参考：《安徽医科大学》2014年硕士论文

【摘要】：背景与目的：颌面部因其较身体其他部位更暴露且受到的保护更少而成为创伤最常见的部位之一，也是全身创伤中最常见的并发受伤部位。平时因交通事故、坠落等意外事故导致颌面部损伤发生率占外伤患者的34%[1]。口腔颌面部外伤所致的皮肤、粘膜损伤和缺损、颌骨骨折等并发症往往会导致患者不同程度的语言、吞咽、咀嚼功能障碍及颌面部畸形。严重影响患者的生活和社交活动，甚至造成极大的生理和心理障碍。因此寻找促进颌面部外伤后软硬组织的快速、完美、生理性修复的方法成为国内外学者研究的热点。外源性生长因子能够促进创伤愈合并且已经被应用于临床，但是由于生长因子价格昂贵，局部使用代谢快、无法在局部持续发挥作用以及使用不便,尤其在口腔粘膜创伤中使用不便而影响其在颌面部创伤治疗临床上的推广使用。尼古丁是香烟的有毒成分之一，有不少报道认为尼古丁对伤口愈合产生了负面的影响，主要通过抑制角化细胞，成纤维细胞和巨噬细胞的增殖与迁移，增加组织血管收缩，减少营养性血流量等机制从而延迟伤口愈合[2-5]。然而最新系列研究发现低浓度尼古丁具有促进血管生成、加速皮肤伤口愈合的作用[6-8]。低浓度尼古丁能否在颌面部软组织创伤修复中，尤其是口腔黏膜创伤修复中发挥作用目前还不清楚。尼古丁具有价格低廉的优点，本实验将通过制备低浓度尼古丁凝胶缓释剂初步观察其对大鼠口腔硬腭软组织缺损修复的影响，为临床加速口腔黏膜创伤修复寻找一种安全、便捷、价格低廉的方法提供新思路、新方法。方法：本实验通过在Wistar大鼠硬腭第一磨牙近中至第三磨牙远中的黏膜作一直径为3mm的圆形切创缺损。术后局部给药，，大鼠随机分成空白对照组、凝胶组、低浓度尼古丁+凝胶组，每组动物分别在3，7，10，14d处死取材拍照，苏木精-伊红（HE）染色观察组织愈合过程，并通过大体标本结合图像测量分析比较各组间伤口愈合率差异。结果与结论:修复后3d各组间愈合情况无明显差异；修复后7，10d组低浓度尼古丁+凝胶组愈合快于凝胶组和空白对照组；修复后14d各组创面已基本愈合，各组间无显著性差异。结论：低浓度尼古丁可能具有促进大鼠硬腭黏膜缺损愈合的作用。
[Abstract]:Background & objective: the maxillofacial region is one of the most common parts of trauma because it is more exposed and less protected than other parts of the body. The incidence of maxillofacial injuries caused by accidents such as traffic accidents and falls was 34%. The complications of oral and maxillofacial trauma, such as skin, mucosal injury and defect, jaw fracture and other complications, often lead to varying degrees of speech, swallowing, masticatory dysfunction and maxillofacial malformation. Seriously affect patients' life and social activities, and even cause great physical and psychological obstacles. Therefore, finding a method to promote the rapid, perfect and physiologic restoration of soft and hard tissue after maxillofacial trauma has become a hot spot of scholars at home and abroad. Exogenous growth factors can promote wound healing and have been used in clinical practice, but because of the high price of growth factors, local use of fast metabolism, can not continue to play a role in the local use and inconvenience. Especially in oral mucosal trauma, the inconvenient use of oral trauma affects its clinical application in maxillofacial trauma treatment. Nicotine is one of the toxic components of cigarettes. There are many reports that nicotine has a negative effect on wound healing, mainly by inhibiting the proliferation and migration of keratinocytes, fibroblasts and macrophages, and increasing tissue vasoconstriction. Mechanisms such as reducing nutritional blood flow delay wound healing [2-5]. However, a new series of studies have found that low-dose nicotine can promote angiogenesis and accelerate skin wound healing [6-8]. It is unclear whether low-concentration nicotine can play a role in the repair of maxillofacial soft tissue trauma, especially in oral mucosal trauma. Nicotine has the advantage of low cost. In this experiment, the effects of low concentration nicotine gel sustained-release agent on the repair of soft tissue defects in the hard palate of the oral cavity in rats were preliminarily observed, and a safe method was found for clinical application to accelerate the repair of oral mucosal trauma. Convenient, low-cost methods provide new ideas, new methods. Methods: in this experiment, the first molar of the hard palate of Wistar rats was cut into the mucosa from the middle of the first molar to the distal part of the third molar to make a circular cut defect with the diameter of 3mm. Rats were randomly divided into blank control group, gel group and low concentration nicotine gel group. The animals in each group were killed and photographed for 14 days. The healing process of tissue was observed by hematoxylin and eosin (HEH) staining. The difference of wound healing rate was compared by gross specimen and image measurement. Results and conclusion: there was no significant difference in healing among the three groups on the 3rd day after repair, the healing rate of the low concentration nicotine gel group was faster than that of the gel group and the blank control group on the 7th day after repair, and the wound surface of each group had basically healed on the 14th day after repair, but there was no significant difference among the groups. Conclusion: low concentration of nicotine may promote the healing of rat hard palate mucosal defect.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R782.4

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