本文選題：纖維蛋白膠 + 自體網(wǎng)狀皮片移植　； 參考：《甘肅農(nóng)業(yè)大學(xué)》2015年碩士論文

【摘要】：隨著我國經(jīng)濟(jì)的發(fā)展,寵物數(shù)量呈現(xiàn)快速增長,由于燒傷、燙傷和車禍等原因造成皮膚缺損的病例數(shù)量也逐漸增多;而自體皮膚移植是治療皮膚缺損的主要手段;在自體皮片移植術(shù)中,移植皮片的成活依靠受體床血管的再生,這就要求植皮手術(shù)中止血要徹底,術(shù)后皮片的固定要穩(wěn)固;而纖維蛋白膠具有固定作用和良好的止血效果。為此,本實驗將纖維蛋白膠應(yīng)用于犬自體皮片移植術(shù)中,以評估纖維蛋白膠對犬自體皮片移植的影響,并從病理組織學(xué)及分子生物學(xué)角度初步探討纖維蛋白膠對移植皮片愈合過程中的作用機理,為纖維蛋白膠應(yīng)用于犬自體網(wǎng)狀皮片移植術(shù)提供理論依據(jù)。本實驗首先建立犬前肢皮膚缺損模型,比較犬自體全厚皮片與網(wǎng)狀皮片的移植效果,選擇一種自體皮片移植成活率較高的自體皮片移植術(shù),然后將纖維蛋白膠應(yīng)用于自體皮片移植術(shù)中作為實驗組,以單純自體皮片移植術(shù)為對照組,于術(shù)后第3、5、7、14和28d觀察記錄犬整體狀態(tài)、移植皮片局部和病理組織學(xué)變化,并采用免疫組織化學(xué)方法檢測移植皮片中4種因子的表達(dá)情況,實驗結(jié)果如下:1.犬自體網(wǎng)狀皮片移植術(shù)與自體全厚皮片移植術(shù)相比,雖然皮片離體時間較長,制備繁瑣,但移植皮片局部引流暢通,炎性反應(yīng)較輕,術(shù)后移植皮片成活率較高,移植效果更好。2.實驗組術(shù)后疼痛反應(yīng)、移植皮片局部滲血和炎癥反應(yīng)較對照著輕微,成纖維細(xì)胞和新生血管數(shù)量提高明顯,表明纖維蛋白膠可加速移植皮膚的愈合,減少瘢痕形成,愈合后的皮膚解剖和生理機能更接近正常皮膚,可提高移植皮膚的愈合質(zhì)量。3.bFGF陽性率的表達(dá):術(shù)后第3、5、7和14d,實驗組和對照組的bFGF陽性率均呈增長趨勢,且實驗組bFGF陽性率均顯著高于對照組(P0.01);術(shù)后第28d,實驗組bFGF陽性率(18.67±0.88)顯著低于對照組(30.67±0.88)(P0.01)。表明纖維蛋白膠可提高移植皮片中bFGF的表達(dá)水平,促進(jìn)成纖維細(xì)胞和血管內(nèi)皮細(xì)胞等靶細(xì)胞的分裂增殖,加快創(chuàng)傷部位的組織修復(fù)和愈合能力。4.VEGF陽性率的表達(dá):術(shù)后第3、5、7和14d,實驗組和對照組VEGF陽性率均呈增長趨勢,且實驗組VEGF陽性率均顯著高于對照組(P0.01);術(shù)后第28d,實驗組VEGF陽性率(21.33±1.45)顯著低于對照組(28.60±1.20)(P0.01)。表明纖維蛋白膠可提高移植皮片中VEGF的表達(dá)水平,促進(jìn)血管內(nèi)皮細(xì)胞向損傷部位遷移并增殖,誘導(dǎo)新血管的形成,增加創(chuàng)傷修復(fù)細(xì)胞的數(shù)量,加快創(chuàng)傷愈合過程,促進(jìn)皮膚愈合。5.基因物質(zhì)P63和整合素β1陽性率的表達(dá):實驗組基因物質(zhì)P63和整合素β1的陽性率都呈先增長后降低的趨勢,第14d均為最高(分別為36.00±1.73和23.67±1.20),第28d分別降至32.33±0.88和19.33±1.20;對照組基因物質(zhì)P63和整合素β1呈增長趨勢,第28d最高(分別為26.33±0.33和17.33±0.88);各時間點實驗組基因物質(zhì)P63陽性率均顯著高于對照組(P0.01),術(shù)后第5、7和14d,實驗組整合素β1陽性率均需顯著高于對照組(P0.01)。表明纖維蛋白膠可提高移植皮片中基因物質(zhì)P63和整合素β1的表達(dá)水平,使表皮干細(xì)胞、血管內(nèi)皮細(xì)胞、巨噬細(xì)胞和成纖維細(xì)胞等修復(fù)細(xì)胞在損傷部位快速增殖,縮短炎性反應(yīng)期,加快皮膚愈合過程。
[Abstract]:With the development of China's economy, the number of pets is increasing rapidly. The number of cases of skin defects caused by burn, scald and car accident is increasing gradually, and autologous skin transplantation is the main method for the treatment of skin defects. In the autologous skin graft, the survival of the skin graft depends on the regeneration of the recipient bed vessel. In this experiment, fibrin glue should be used in canine skin graft to evaluate the effect of fibrin glue on the autologous skin graft of dogs, and from the histopathology and molecular biology angles. The mechanism of fibrin glue on the healing process of skin graft was discussed. It provided a theoretical basis for the use of fibrin glue for autologous reticular skin graft in dogs. First of all, the skin defect model of the canine forelimb was established, and the graft effect of autologous skin autograft and reticular skin graft was compared, and a high survival rate of autologous skin graft was selected. In autologous skin graft, fibrin glue should be used as an experimental group in autologous skin graft, and the autologous skin graft was used as the control group. The whole state of the dog was recorded at 3,5,7,14 and 28d postoperatively. The local and histopathological changes of the skin graft were observed, and 4 factors in the skin graft were detected by immunohistochemistry. The results of the expression were as follows: 1. compared with the autologous skin graft and autologous skin graft, the skin graft has a long time and complicated preparation, but the local drainage of the skin graft is smooth, the inflammatory reaction is lighter, the survival rate of the skin graft is higher after the operation, and the effect of transplantation is better in the.2. experimental group after the operation and the graft skin graft. The number of local blood infiltration and inflammation was less than that of the control. The number of fibroblasts and neovascularization increased obviously. It showed that fibrin glue could accelerate the healing of skin graft and reduce scar formation. The anatomical and physiological function of skin after healing was closer to normal skin. The expression of.3.bFGF positive rate of skin graft skin healing was increased: third after operation. 5,7 and 14d, the positive rate of bFGF in the experimental group and the control group all increased, and the positive rate of bFGF in the experimental group was significantly higher than that in the control group (P0.01). The positive rate of bFGF in the experimental group (18.67 + 0.88) was significantly lower than that of the control group (30.67 + 0.88) (P0.01). The proliferation of target cells, such as cell and vascular endothelial cells, accelerated the expression of.4.VEGF positive rate of tissue repair and healing in the trauma site: the positive rates of VEGF were increased in both 3,5,7 and 14d after operation, and the positive rate of VEGF in the experimental group and the control group was significantly higher than that in the control group (P0.01), and the positive rate of VEGF in the experimental group was 21.33 after the operation (21.33 + 1.45) was significantly lower than that of the control group (28.60 + 1.20) (P0.01). It showed that fibrin glue could improve the expression level of VEGF in the skin graft, promote the migration and proliferation of vascular endothelial cells to the injured part, induce the formation of new blood vessels, increase the number of wound healing cells, accelerate the healing process, and promote the healing of the skin healing.5. gene P63 and integration. Expression of the positive rate of prime beta 1: the positive rate of P63 and integrin beta 1 in the experimental group showed a tendency to increase first, and the highest (36 + 1.73 and 23.67 + 1.20 respectively), and 28d to 32.33 + 0.88 and 19.33 + 1.20, respectively, P63 and integrin beta 1 in the control group, and the highest 28d (26.33 + 0.33, respectively). The positive rate of P63 in the experimental group was significantly higher than that of the control group (P0.01). The positive rate of integrin beta 1 in the experimental group was significantly higher than that of the control group (P0.01). The results showed that the fibrin glue could improve the expression of P63 and integrin beta 1 in the skin graft, and make the epidermal stem cells and vascular endothelium in the skin graft. Cells, macrophages and fibroblasts and other repair cells rapidly proliferate at the injured site, shorten the inflammatory response period, and accelerate the healing process of skin.
【學(xué)位授予單位】：甘肅農(nóng)業(yè)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：S857.1

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