摘要
目的探讨透明质酸对扩张囊外纤维包膜的厚度、胶原纤维含量、毛细血管数量、成肌纤维细胞数量及其微细结构等的作用。方法 2008年3月至2012年10月收治的行皮肤软组织扩张术治疗的患者共28例。采用自体对照,在患者病变周围,于皮下浅筋膜深层剥离足够大的腔隙,两侧各埋植相同容量皮肤软组织扩张器1枚,其中一侧将1%医用透明质酸钠凝胶3mL均匀涂布于剥离腔隙的周壁,设为试验组,另一侧设为对照组,观察2组扩张囊外纤维包膜的厚度、成肌纤维细胞的形态及分布差异。结果应用显微标尺测量苏木素-伊红(HE)染色切片中扩张包膜的厚度。实验组包膜厚度为(452±45)μm,对照组包膜厚度为(839±55)μm,2组比较差异有统计学意义(P<0.05)。实验组中幼稚期的成纤维细胞数目明显比对照组多;而对照组中成熟期的成纤维细胞即纤维细胞数目较多。结论透明质酸可以抑制成纤维细胞向成肌纤维细胞的转化,并抑制胶原的合成和分泌,使得扩张包膜变薄,胶原纤维含量降低,收缩性下降,从而减轻带纤维包膜扩张皮瓣的收缩率,提高手术疗效;并且未发现血运受到影响。
Objective To study the effect of Hyaluronic acid on the thickness, collagen content, the number of capillaries, the number of myofibroblast and its changes in micro-structure of the fibrocapsule wrapped around the inflatable bag. Methods From March 2008 to October 2012,28 patients were treated with skin soft tissue ex- pansion by the method of self-comparison. Around the lesion,a lacuna of proper size was dissected in the deep lay- er of subcutaneous superficial fascia,and the same capacity of soft tissue expanders was buried on its both sides, with 3 mL 1 ~ hyaluronic acid applied on the lacuna on one side as the experimental group,and the other side as the control group to observe the thickness of the fibrocapsule, differentiation of the shape and the distribution of the myofibroblast. Results Microscopic scale is used to measure the thickness of fibrocapsule on HE sections. The fibrocapsule thickness of experimental group is （452q-45）t^m and as to the control group is （839±55）μm, with significant difference between the two groups （P〈0.05） in statistics. The number of naive fibroblasts in the experimental group is larger than that in the control group, and there are more mature fibroblasts in the control group. Conclusion Hyaluronic acid can inhibit both the conversion from fibroblast to myofibroblast and the synthesis and secretion of collagen, make the fibrocapsule thinning and collagen fiber content decreasing, and decrease the contractility. Eventually the contraction of the skin expansion flap with fibrocapsule is reduced and surgical outcome is improved without any noticeable impact on blood circulation.
出处
《山西医药杂志（上半月）》
CAS
2013年第5期504-506,I0002,共4页
Shanxi Medical Journal
关键词
透明质酸
外科皮瓣
成肌纤维细胞
皮肤扩张术
Hyaluronic acid
Surgical flaps
Myofibroblast
Skin and soft tissue expansion
