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目的 探讨确炎舒松对扩张纤维囊组织结构及扩张过程的影响及其机制。方法 对 2 4例成年患者按部位随机分为用药组和对照组 ,用药组于扩张器置入后 1周向扩张囊外周注入确炎舒松 (悬液 ) 2 0～ 40mg。两组同时开始扩张 ,注水间隔均为 48h ,每次注水均使扩张器表面皮肤变韧。记录每例达到 5 0 %和完成扩张容量的时间 (天 ) ,第二次手术时切取纤维包膜及皮瓣进行组织学观察。结果 用药组达到 5 0 %和 10 0 %容量所需时间分别为 (10± 3)天和 (2 4±4)天 ,对照组分别为 (14± 3 5 )天和 (40± 5 )天 ,两组对比差异有显著性 (P <0 0 5和P <0 0 1)。组织学观察 :纤维包膜均分肉芽层和胶原纤维层 ,用药组两层均较薄 ,肉芽层炎细胞数目少 ,血管少且细 ,纤维层胶原稀疏、薄 ,仅有少量成肌纤维细胞 ;对照组则相反。两组真皮均变薄 ,未见有纤维断裂现象。结论 扩张术后早期局部应用确炎舒松可有效控制扩张纤维囊增生 ,加快扩张速率 ,且对皮瓣质量无影响
Objective To investigate the effect of Yanshu Song on the structure and expansion of expanded fibrous capsule and its mechanism. Methods Twenty-four adult patients were randomly divided into medication group and control group according to the site. The patients in the medication group were infused with 20 ~ 40 mg of Yanshu Song (suspension) 1 week after dilator placement. Both groups began to expand at the same time, the water injection interval is 48h, each time the water is made to dilate the surface of the dilator skin. Record each case reached 50% and the completion of the expansion capacity of the time (days), the second operation cut fibrous capsule and flap for histological observation. Results The time required to achieve 50% and 100% volume was (10 ± 3) days and (24 ± 4) days in the drug group and (14 ± 3.5 days) and (40 ± 5) days in the control group There was significant difference between the two groups (P <0.05 and P <0.01). Histological observation: The fibrous capsule was evenly divided into granulation layer and collagen fiber layer. The two groups in the medication group were thinner. The number of granulomatous inflammatory cells was less, the blood vessels were less and thinner, the collagen in the fibrous layer was sparse and thin, with only a few myofibroblasts; The control group is the opposite. Both groups of dermis thinning, no fiber breakage phenomenon. Conclusions The local application of Yasurasong in the early postoperative expansion can effectively control the expansion of fibrocytes, accelerate the expansion rate and have no effect on the quality of the flaps