發(fā)布時間：2018-05-16 00:09

  本文選題：尼古丁 + 軟組織缺損�。� 參考：《安徽醫(yī)科大學(xué)》2014年碩士論文

【摘要】：背景與目的：頜面部因其較身體其他部位更暴露且受到的保護(hù)更少而成為創(chuàng)傷最常見的部位之一，也是全身創(chuàng)傷中最常見的并發(fā)受傷部位。平時因交通事故、墜落等意外事故導(dǎo)致頜面部損傷發(fā)生率占外傷患者的34%[1]。口腔頜面部外傷所致的皮膚、粘膜損傷和缺損、頜骨骨折等并發(fā)癥往往會導(dǎo)致患者不同程度的語言、吞咽、咀嚼功能障礙及頜面部畸形。嚴(yán)重影響患者的生活和社交活動，甚至造成極大的生理和心理障礙。因此尋找促進(jìn)頜面部外傷后軟硬組織的快速、完美、生理性修復(fù)的方法成為國內(nèi)外學(xué)者研究的熱點。 外源性生長因子能夠促進(jìn)創(chuàng)傷愈合并且已經(jīng)被應(yīng)用于臨床，但是由于生長因子價格昂貴，局部使用代謝快、無法在局部持續(xù)發(fā)揮作用以及使用不便,尤其在口腔粘膜創(chuàng)傷中使用不便而影響其在頜面部創(chuàng)傷治療臨床上的推廣使用。尼古丁是香煙的有毒成分之一，有不少報道認(rèn)為尼古丁對傷口愈合產(chǎn)生了負(fù)面的影響，主要通過抑制角化細(xì)胞，成纖維細(xì)胞和巨噬細(xì)胞的增殖與遷移，增加組織血管收縮，減少營養(yǎng)性血流量等機(jī)制從而延遲傷口愈合[2-5]。然而最新系列研究發(fā)現(xiàn)低濃度尼古丁具有促進(jìn)血管生成、加速皮膚傷口愈合的作用[6-8]。低濃度尼古丁能否在頜面部軟組織創(chuàng)傷修復(fù)中，尤其是口腔黏膜創(chuàng)傷修復(fù)中發(fā)揮作用目前還不清楚。尼古丁具有價格低廉的優(yōu)點，本實驗將通過制備低濃度尼古丁凝膠緩釋劑初步觀察其對大鼠口腔硬腭軟組織缺損修復(fù)的影響，為臨床加速口腔黏膜創(chuàng)傷修復(fù)尋找一種安全、便捷、價格低廉的方法提供新思路、新方法。 方法：本實驗通過在Wistar大鼠硬腭第一磨牙近中至第三磨牙遠(yuǎn)中的黏膜作一直徑為3mm的圓形切創(chuàng)缺損。術(shù)后局部給藥，，大鼠隨機(jī)分成空白對照組、凝膠組、低濃度尼古丁+凝膠組，每組動物分別在3，7，10，14d處死取材拍照，蘇木精-伊紅（HE）染色觀察組織愈合過程，并通過大體標(biāo)本結(jié)合圖像測量分析比較各組間傷口愈合率差異。 結(jié)果與結(jié)論:修復(fù)后3d各組間愈合情況無明顯差異；修復(fù)后7，10d組低濃度尼古丁+凝膠組愈合快于凝膠組和空白對照組；修復(fù)后14d各組創(chuàng)面已基本愈合，各組間無顯著性差異。結(jié)論：低濃度尼古丁可能具有促進(jìn)大鼠硬腭黏膜缺損愈合的作用。
[Abstract]:Background & objective: the maxillofacial region is one of the most common parts of trauma because it is more exposed and less protected than other parts of the body. The incidence of maxillofacial injuries caused by accidents such as traffic accidents and falls was 34%. The complications of oral and maxillofacial trauma, such as skin, mucosal injury and defect, jaw fracture and other complications, often lead to varying degrees of speech, swallowing, masticatory dysfunction and maxillofacial malformation. Seriously affect patients' life and social activities, and even cause great physical and psychological obstacles. Therefore, finding a method to promote the rapid, perfect and physiologic restoration of soft and hard tissue after maxillofacial trauma has become a hot spot of scholars at home and abroad. Exogenous growth factors can promote wound healing and have been used in clinical practice, but because of the high price of growth factors, local use of fast metabolism, can not continue to play a role in the local use and inconvenience. Especially in oral mucosal trauma, the inconvenient use of oral trauma affects its clinical application in maxillofacial trauma treatment. Nicotine is one of the toxic components of cigarettes. There are many reports that nicotine has a negative effect on wound healing, mainly by inhibiting the proliferation and migration of keratinocytes, fibroblasts and macrophages, and increasing tissue vasoconstriction. Mechanisms such as reducing nutritional blood flow delay wound healing [2-5]. However, a new series of studies have found that low-dose nicotine can promote angiogenesis and accelerate skin wound healing [6-8]. It is unclear whether low-concentration nicotine can play a role in the repair of maxillofacial soft tissue trauma, especially in oral mucosal trauma. Nicotine has the advantage of low cost. In this experiment, the effects of low concentration nicotine gel sustained-release agent on the repair of soft tissue defects in the hard palate of the oral cavity in rats were preliminarily observed, and a safe method was found for clinical application to accelerate the repair of oral mucosal trauma. Convenient, low-cost methods provide new ideas, new methods. Methods: in this experiment, the first molar of the hard palate of Wistar rats was cut into the mucosa from the middle of the first molar to the distal part of the third molar to make a circular cut defect with the diameter of 3mm. Rats were randomly divided into blank control group, gel group and low concentration nicotine gel group. The animals in each group were killed and photographed for 14 days. The healing process of tissue was observed by hematoxylin and eosin (HEH) staining. The difference of wound healing rate was compared by gross specimen and image measurement. Results and conclusion: there was no significant difference in healing among the three groups on the 3rd day after repair, the healing rate of the low concentration nicotine gel group was faster than that of the gel group and the blank control group on the 7th day after repair, and the wound surface of each group had basically healed on the 14th day after repair, but there was no significant difference among the groups. Conclusion: low concentration of nicotine may promote the healing of rat hard palate mucosal defect.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R782.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 屈紀(jì)富,郝利,孫薇,程天民;細(xì)胞因子在創(chuàng)傷愈合過程中的變化及其意義的研究進(jìn)展[J];創(chuàng)傷外科雜志;2003年01期

2 李仕明;糖尿病足的臨床診斷與治療進(jìn)展[J];內(nèi)科急危重癥雜志;2002年01期

3 景璐石,田蕓,張曉,馮軍;成纖維細(xì)胞生長因子在胚胎發(fā)育和創(chuàng)面愈合中的作用[J];中國臨床康復(fù);2003年08期

4 何錦泉;張益;;頜面創(chuàng)傷調(diào)查現(xiàn)況[J];中國口腔頜面外科雜志;2006年05期

5 付小兵,孫同柱,盛志勇;幾種用于創(chuàng)傷修復(fù)研究的動物模型[J];中華實驗外科雜志;1999年05期

6 江捍平,王大平,張洪;軟組織缺損修復(fù)研究進(jìn)展[J];中國現(xiàn)代醫(yī)學(xué)雜志;2004年21期

本文編號：1894559