發(fā)布時間：2018-07-06 09:00

  本文選題：微等離子體射頻技術(shù) + 增生性瘢痕　； 參考：《河北醫(yī)科大學》2017年碩士論文

【摘要】：目的:微等離子體射頻(Micro-Plasma Radiofrequency,簡稱MPR)現(xiàn)已廣泛應(yīng)用于面部除皺、換膚、淺表瘢痕的治療等多種臨床疾病,但對于增生性瘢痕(Hypertrophic Scar,簡稱HS)的作用機制研究較少,本實驗通過對比研究的方法來探索兔耳HS應(yīng)用MPR治療后其大體形態(tài)的變化和其中單核細胞趨化蛋白-1(monocyte chemotactic protein-1,簡稱MCP-1)的表達變化,為MPR治療早期HS提供實驗依據(jù)。方法:將6只新西蘭大耳白兔在實驗室分籠適應(yīng)性飼養(yǎng)48小時后,參照李薈元等兔耳增生性瘢痕模型的制作方法,在全麻下于每只兔耳中段腹側(cè)面,沿長軸,使用8mm直徑規(guī)格圓形環(huán)鉆做6個圓形深達軟骨膜的創(chuàng)面,圓形創(chuàng)面間隔1.5cm,6只新西蘭大白兔共形成72個創(chuàng)面。造模術(shù)后3天左右創(chuàng)面結(jié)痂,7天左右完成上皮化,28天創(chuàng)面組織進入瘢痕增生高峰期,并持續(xù)1周左右;此時所形成創(chuàng)面表面痂皮脫落,大部分瘢痕高于皮膚表面,呈紅色、質(zhì)地較硬。造模術(shù)后28天,觀察到6只兔子共形成72處瘢痕,然后將每只兔子的雙耳隨機平均分配到實驗組和對照組。于兔耳增生性瘢痕造模術(shù)后第30天,對實驗組36處增生性瘢痕進行微等離子體射頻治療。治療參數(shù)為滾輪治療頭,0.6ms,80w。滾輪頭治療時輕按治療頭并保持治療頭與皮膚垂直,在治療區(qū)內(nèi)勻速滾動(約6cm/s),共治療1次。治療后實驗組增生性瘢痕表面外用紅霉素軟膏,每日1次,用藥1周。對照組所有36處增生性瘢痕表面外用紅霉素軟膏,每日1次,用藥1周;不進行微等離子體射頻治療。造模60天后切取實驗組和對照組HS組織制作標本,切片后進行組織學研究,并采用免疫組化檢測瘢痕內(nèi)MCP-1含量。此后應(yīng)用ImagePro Plus 6.0(Media Cybernetics)圖像處理軟件統(tǒng)計出每視野的MCP-1染色陽性細胞的所占的面積及其積分平均光密度值,并將此平均光密度值采用SPSS軟件進行t檢驗。結(jié)果:1肉眼觀結(jié)果治療組HS采用MPR治療后平均2.4±1.5天痂皮脫落。痂皮脫落后,治療區(qū)域均未見創(chuàng)面存在。MPR治療區(qū)域的HS與對照組相比,顏色變淺,呈淡紅色,質(zhì)地變軟,瘢痕的高度變低。2組織學結(jié)果對照組真皮層較薄,成纖維細胞增生,膠原纖維增生且排列紊亂。實驗組未見壞死組織在表皮淺層殘留,成纖維細胞增生不明顯,膠原纖維增生少于對照組,且排列相對整齊。3 MCP-1免疫組化結(jié)果及統(tǒng)計分析兩組MCP-1染色陽性細胞的平均光密度值經(jīng)比較t檢驗,t值為6.48,P=0.00,按照P0.05的標準,有統(tǒng)計學意義。結(jié)論:1 MPR對早期兔耳增生性瘢痕治療有效。2 MPR抑制了MCP-1的合成,從而降低了成纖維細胞異常增殖、抑制了瘢痕增生。
[Abstract]:Objective: Micro-Plasma Radio Frequency (MPR) has been widely used in the treatment of facial wrinkle, skin replacement, superficial scar and other clinical diseases, but the mechanism of hypertrophic scar (HS) is less studied. The purpose of this study was to explore the changes of gross morphology and the expression of monocyte chemoattractant protein 1 (monocyte chemotactic protein-1 (MCP-1) in rabbit ears after MPR therapy, and to provide experimental evidence for the early treatment of HS. Methods: six New Zealand big ear white rabbits were fed in a laboratory cage for 48 hours. According to the method of making hypertrophic scar model of rabbit ear such as Li Yuanyuan, under general anesthesia, 6 rabbits were placed on the ventral side of each rabbit ear, along the long axis. A total of 72 wounds were formed in 6 New Zealand white rabbits with a circular wound interval of 1.5 cm ~ (-1) by using 8mm diameter specification circular annular drill to form 6 round deep chondrocytes. The wound tissue reached the peak of scar proliferation in 28 days after modeling 3 days after operation, and lasted for about 1 week, most of the scar was higher than the skin surface, and the wound tissue was red, and the wound tissue had reached the peak of scar proliferation in 28 days after model making, and most of the scar was higher than the skin surface, and the scar was red. The texture is hard. On the 28th day after modeling, 72 scars were observed in 6 rabbits, and each rabbit's ears were assigned to the experimental group and the control group at random. 36 hypertrophic scars in experimental group were treated with microplasma radiofrequency on the 30th day after modeling hypertrophic scar in rabbit ear. The parameters of the treatment were as follows: 0. 6 Ms for 80 ws. Press the healing head and keep the head perpendicular to the skin when the roller head is treated, and roll uniformly in the treatment area (about 6cm/s) for a total of 1 time. The experimental group was treated with erythromycin ointment once a day for 1 week. All 36 hypertrophic scars in the control group were treated with erythromycin ointment once a day for 1 week. After 60 days of model making, the HS tissues of the experimental group and the control group were cut to make the specimens, and the histological study was carried out, and the MCP-1 content in the scar was detected by immunohistochemistry. After that, the area of MCP-1 staining positive cells and their integral mean optical density were calculated by Image Pro Plus 6.0 (Media Cybernetics) image processing software, and the mean optical density was tested by SPSS software. Results the mean eschar of HS group was 2.4 鹵1.5 days after MPR treatment. After exfoliation of callus, there was no HS in the treatment area. Compared with the control group, HS of the treatment area was lighter, softer, and the height of scar was lower. 2 the histopathological results showed that the dermis of the control group was thinner and fibroblasts proliferated. Collagen fibers proliferate and are disordered. In the experimental group, no necrotic tissue remained in the superficial epidermis, fibroblast proliferation was not obvious, and collagen proliferation was less than that in the control group. The average optical density of MCP-1 staining positive cells in the two groups was 6.48 P0. 00by t test, which was statistically significant according to the standard of P0.05. Conclusion in the treatment of early hypertrophic scar of rabbit ear, 1: 1 MPR can effectively inhibit the synthesis of MCP-1, thus decrease the abnormal proliferation of fibroblasts and inhibit the proliferation of scar.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R622

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