【摘要】 目的建立猪深Ⅱ度烫伤模型,观察早期磨痂术创面的组织学改变及细胞角蛋白(CK)和表皮生长因子受体(EGFR)的表达。方法选用实验用小型猪制备深Ⅱ度烫伤模型,于烫伤早期(烫伤后3 h)分别实施磨痂术(磨痂组,n=96)、常规削痂术治疗(削痂组,n=96)和SD-Ag保痂处理(SD-Ag组,n=96)。记录各组创面愈合时间;于烫伤后12 h和1、2、3、5、7、10、20 d分别采集创面皮肤样本,HE染色和免疫组化染色分别观察创面组织学变化及CK和EGFR表达。结果磨痂组创面愈合时间明显短于削痂组和SD-Ag组(P<0.05)。组织学观察发现,与削痂组和SD-Ag组比较,磨痂组烫伤后3、5 d真皮深层组织炎细胞浸润和毛细血管淤滞较轻,皮肤附件破坏较少。免疫组化染色显示,烫伤后5、7 d磨痂组CK和EGFR表达较削痂组和SD-Ag组显著,保留皮肤附件较多,创面上皮化快,新生表皮厚。结论深Ⅱ度烫伤创面实施早期磨痂术可保留较多皮肤附件,通过提高局部CK和EGFR释放而使创面上皮化提前,加速创面愈合并改善愈合质量。更多还原

【Abstract】 Objective To establish the model of porcine deep second degree burn,and observe the histological changes and expression of cytokeratin(CK) and epidermal growth factor receptor(EGFR) of dermabrasion wound in early stage.Methods Porcine deep second degree burn models were established,and were treated with wound abrasion(dermabrasion group,n=96), tangential excision(tangential group,n=96) and SD-Ag(SD-Ag group,n=96),respectively in early stage after burn.The time of wound healing was observed.The wound samples were obtained 12h,1d,2d,3d,5d, 7d,10d and 20d after burn,and histological changes and expression of CK and EGFR of wound were observed by HE staining and immunohistochemical staining,respectively. Results The time of wound healing was significantly shorter in dermabrasion group than that in tangential group and SD-Ag group(P<0.05).It was indicated by histological observations that the inflammatory cell infiltration and capillary congestion were more moderate and more skin appendages were reserved in dermabrasion group than those in tangential group and SD-Ag group 3 and 5 d after burn.It was revealed by immunohistochemical staining that the expression of CK and EGFR in dermabrasion group was higher than that in tangential group and SD-Ag group 5 and 7 d after burn,and more skin appendages were reserved and more wound epithelization was found. Conclusion Wound abrasion for deep second degree burn in early stage may reserve more skin appendages,stimulate wound epithelization by increasing expression of CK and EGFR and promoting wound healing.更多还原