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背景:已证实单层人羊膜覆盖对浅度烧伤创面有一定的治疗作用,但仍存在很多不足。目的:观察自制复层辐射人羊膜覆盖治疗对鼠深Ⅱ度烫伤创面的效果。设计、时间及地点:随机分组,自身及组间对照动物实验,于2006-12/2007-05在哈尔滨医科大学第一临床医学院动物实验中心进行。材料:成年清洁级Wistar大鼠50只,随机分为伤后4,6,8,10,12d组5组,每组10只。复层辐射人羊膜为自制,将新鲜人羊膜去除绒毛膜后,将羊膜层干燥,制成无孔及有孔的复层薄膜,再经γ射线辐射后塑膜包装。方法:所有动物背部脱毛,麻醉后浸入沸水中8s致背部烫伤,制备深Ⅱ度烫伤模型。将每组创面积2等分,分别贴敷复层辐射人羊膜和油纱进行对照观察。主要观察指标:在伤后4,6,8,10,12d取材,观察创面大体愈合情况,光镜、扫描电镜、透射电镜观察创面组织学变化,并进行创面细菌学检查。结果:50只大鼠全部进入结果分析。①贴敷油纱的创面:可见坏死物和痂皮,伤后12d时肉眼仍见灶性小溃疡,光镜下见生真皮层少量毛囊、毛根、毛发再生,扫描电镜下见创面中心为坏死结痂,周边见少量毛发,大量炎性渗出物及白细胞存在,透射电镜显示细胞结构模糊不清。细菌学检查结果显示创面细菌生长明显。②贴敷复层辐射人羊膜创面:伤后10,12d时创面愈合,肉眼见毛发规则丛生,和正常皮肤无区别,光镜、扫描电镜、透射电镜观察均显示伤后12d时表皮各层均为正常皮肤组织。细菌学检查结果显示创面无细菌生长。结论:复层辐射人羊膜能能有效地保护鼠烫伤创面,促进创面的上皮生长,避免创面感染,缩短鼠深Ⅱ度烫伤创面的愈合时间。
Background: It has been confirmed that monolayer human amniotic membrane has a certain therapeutic effect on superficial burn wounds, but there are still many deficiencies. Objective: To observe the effect of self-made radiofrequency amniotic membrane covering on deep partial thickness scald wound in rats. DESIGN, TIME AND SETTING: Randomized groups, self and group control animal experiments were performed at the Animal Experimental Center of Harbin Medical University No.1 School of Clinical Medicine from December 2006 to May 2007. MATERIALS: Fifty adult Wistar rats were randomly divided into 4 groups (4, 6, 8, 10, and 12 days), with 10 rats in each group. Laminated human amniotic membrane radiation for self-made, fresh human amniotic membrane to remove the chorion, the amniotic layer dried, made of non-porous and porous laminated film, and then by γ-ray radiation plastic packaging. Methods: All animals were depilated on the back, anesthetized and immersed in boiling water for 8s to cause burns on the back. A deep second degree scald model was prepared. The area of each group was divided into 2 equal parts, respectively, stained double-coated radiation amniotic membrane and gauze for control. MAIN OUTCOME MEASURES: Gross wound healing was observed at 4, 6, 8, 10 and 12 days after injury. Histological changes of the wound were observed under light microscope, scanning electron microscope and transmission electron microscope. Bacteriological examination was also performed. Results: All 50 rats entered the result analysis. ① sticking oil gauze wound: visible necrosis and crusts, 12d after injury still see the focal small ulcer, under the light microscope see a small number of dermal cortex hair follicles, hair roots, hair regeneration, under the scanning electron microscope to see the center of the wound as necrosis Crusting, see a small amount of hair around, a large number of inflammatory exudates and the presence of white blood cells, transmission electron microscopy showed the cell structure blurred. Bacteriological examination showed that the bacterial growth of the wound was obvious. (2) Sticking radiofrequency amniotic membrane wound: the wound healed at 10 and 12 days after injury, and the hair was irregular in appearance. There was no difference between the amniotic membrane and normal skin. The observation of light microscope, scanning electron microscope and transmission electron microscope showed that the layers of epidermis For normal skin tissue. Bacteriological examination showed no bacterial growth in the wound. Conclusion: The radiation of human amniotic membrane can effectively protect the scald wounds, promote epithelial growth, avoid wound infection and shorten the healing time of deep second-degree scald wounds in rats.