【摘要】 目的比较聚氨酯和聚乙稀醇这两种海绵材料在负压吸引下对大鼠肉芽组织增生的影响。方法 16只雄性SPF级大鼠按随机原则分为2组,每组8只,肩胛间区做沿背部中线纵形、长约2 cm的全层皮肤切开伤口后,按植入海绵(聚氨酯或聚乙烯醇)不同视为聚氨酯组及聚乙稀醇组,术后30 d处死大鼠,取出植入海绵,通过对植入海绵标本的大体观察,通过苏木精-伊红(HE)染色、Masson三色染色观察胶原沉积情况,组织学检验方法比较两组标本的巨噬细胞、α平滑肌肌动蛋白(α-SMA)肌成纤维细胞、CD31、Ki67、转化生长因子-β1(TGF-β1)这5个指标的阳性细胞个数的差异,以比较两种海绵材料诱导局部血管化及肉芽组织生长的差异。结果聚氨酯组海绵体积(0.41±0.18)cm3与聚乙稀醇组(0.82±0.13)cm3比较,体积明显缩小;HE染色及Masson三色染色结果显示,聚氨酯组海绵内肉芽组织量多,遍布全层,有较多小血管生成,胶原纤维沉积量多,而聚乙稀醇组肉芽组织仅长入海绵外层,量少,血管化程度低且胶原纤维沉积量少。免疫组织化学检测显示,海绵内巨噬细胞阳性染色的相对细胞个数聚氨酯组为(70.25±3.87)个,聚乙稀醇组为(22.38±2.90)个,两组比较差异有统计学意义(t=1.761,P<0.05);海绵内α-SMA阳性染色的肌成纤维细胞个数聚氨酯组为(57.63±1.21)个,聚乙稀醇组为(17.50±1.18)个,两组比较差异有统计学意义(t=1.761,P<0.05);海绵内CD31阳性血管数量聚氨酯组为(53.25±0.94)个,聚乙稀醇组为(14.25±1.57)个,两组比较差异有统计学意义(t=1.761,P<0.05);海绵内的Ki67阳性细胞数目聚氨酯组为(69.00±3.32)个,聚乙稀醇组(10.75±0.88)个,两组比较差异有统计学意义(t=1.761,P<0.05);海绵内TGF-β1细胞因子阳性染色的相对数量聚氨酯组为(64.25±3.05)个,聚乙稀醇组为(19.63±1.13)个,两组比较差异有统计学意义(t=1.761,P<0.05)。结论在同样的负压吸引条件下,创面应用聚氨酯较使用聚乙稀醇,在促进局部血管化及肉芽组织生长方面均具有优势。更多还原

【Abstract】 Obiective To compare efficacy of two kinds of polyurethane and polyvinyl alcohol sponge material when pressure suction on rat granulation tissure hyperplasiavacuum drainage. Methods With full-thickness skin incision wound created in back area,sixteen male SPF rats were randomly divided into two groups then implanted subcutaneously with ether polyurethane sponge( polyurethane group) or polyvinyl alcohol sponge( polyvinyl alcohol group). All the mice were sacrificed on 30 d post-operation. The implants were collected and stained by the technique of histopathology( HE and Masson’ s trichrom staining for collagen deposition evaluation,F4 /80,α-smooth muscle actin,CD31,Ki67 and transforming growth factor beta-β1 immumohistochemical staining for in situ vascularization and granulation tissue formation exam) for the qualitative results of staining were compared. Results For the polyurethane group,the sponges were significantly reduced [( 0. 41 ± 0. 18) cm3vs( 0. 82 ± 0. 13) cm3]. As shown by HE and Masson’s trichrom staining,bigger amount of granulation tissue,new formed blood vessles and collagen were found in polyurethane spongs relative to polyvinyl alcohol sponges. Compared with the polyvinyl alcohol group,the number of F4 /80 positive macrophages( 70. 25 ± 3. 87 vs. 22. 38 ± 2. 90),α-smooth muscle actin positive myofibroblasts( 57. 63 ± 1. 21 vs. 17. 50 ± 1. 18),CD31 positive vessels( 53. 25 ± 0. 94 vs.14. 25 ± 1. 57),Ki67 positive cells( 69. 00 ± 3. 32 vs. 10. 75 ± 0. 88) and transforming growth factor beta-β1 positive cytokines( 64. 25 ± 3. 05 vs. 19. 63 ± 1. 13) were found increased in the study group( P <0. 05). Conclusion Compared with polyvinyl alcohol, polyurethane may have advantages in local angiogenesis and granulation tissueinduction.更多还原