【作者】 沈建国；

【导师】 陈维善；

【作者基本信息】 浙江大学 ， 外科学， 2007， 硕士

【摘要】 目的探讨恒磁场对SD大鼠深创面愈合的影响;探讨恒磁场对创面愈合过程中VEGF表达的影响;探讨不同强度恒磁场治疗SD大鼠深创面的区别。方法将48只清洁级SD大鼠随机分成0.16T磁疗组、0.32T磁疗组和对照组。分别在术后第3、6、9、12天每组处死4只大鼠,大体观察创面情况;测定创面愈合指数;对肉芽组织进行病理组织学观察;免疫组化检测肉芽组织VEGF表达。使用统计软件SPSS 12.0作统计学处理,计量数据处理以X±s表示,样本均数之间的比较用t检验。等级资料用数值变量(N)表示,两个样本之间的比较采用Wilcoxon秩和检验。结果大体观察:在整个愈合过程中,0.16T磁疗组、0.32T磁疗组创面渗出多,肉芽生长快。上皮出现早,愈合时间短。0.32T磁疗组与0.16T磁疗组相比,创面渗出物量更多,肉芽生长更加旺盛,上皮出现及愈合时间也略早些。对照组创面渗出少,肉芽生长量少且缓慢,上皮出现较迟,创面愈合明显比磁疗组慢。愈合指数:磁疗组在第3、6、9、12天时的愈合指数明显高于对照组,差异有统计学意义。0.32T磁疗组高于0.16T磁疗组,差异有统计学意义。组织学观察早期磁疗组可见毛细血管数量较多,管腔较粗,成纤维细胞数量多,胞体大,肉芽组织层较厚,以0.32T磁疗组最明显。对照组毛细血管较少,且管腔狭窄,成纤维细胞数量也较少。中期磁疗组创面肉芽组织毛细血管数量更多,管腔扩大,毛细血管内皮细胞体积较大,有较多成纤维细胞变为纤维细胞,创缘上皮组织明显增生。对照组毛细血管、成纤维细胞及胶原纤维量少,毛细血管管腔较狭窄,且胶原纤维粗细不均、排列紊乱,创缘上皮组织细胞少。晚期磁疗组毛细血管较9天时明显减少,成纤维细胞也减少,胶原纤维进一步增多。上皮爬行明显,接近闭合。对照组毛细血管也有所减少,成纤维细胞较多。胶原纤维也进一步增多,但仍少于磁疗组,上皮爬行及分化也弱于磁疗组。在创面愈合过程中,毛细血管数及成纤维细胞数磁疗组与对照组相比差异有统计学意义,0.32T磁疗组与0.16T磁疗组相比差异有统计学意义。创面修复不同时期VEGF表达观察结果:在术后第3、6天磁疗组VEGF表达强于对照组,差异有统计学意义。第9、12天磁疗组与对照组相比,差异无统计学意义(P＞0.05)。0.32T磁疗组VEGF表达阳性率在第3、6天明显高于0.16T磁疗组,差异有统计学意义。两个磁疗组在第6天时VEGF阳性率达到整个愈合过程中的峰值,而对照组在第9天时才达到高峰,且VEGF表达强度低于两个磁疗组。结论1、0.16T恒磁片及0.32T恒磁片均能促进SD大鼠深创面的愈合;2、恒磁场促进深创面愈合的机制可能和在创面愈合早、中期增强VEGF的表达有关;3、应用0.32T恒磁片能使SD大鼠深创面在愈合过程早、中期VEGF表达高于应用0.16T恒磁片的创面,可能和磁场强度越高,促进成纤维细胞和血管内皮细胞产生定向移动的速度越快有关。更多还原

【Abstract】 Objective:To investigate the effect of static magnetic field on deep wound healing of SD rats;to investigate the effect of static magnetic field on VEGF during the course of wound healing;to investigate the effect of different strength static magnetic field on deep wound healing of SD rats.Methods:Dividing forty-eight SD rats into three groups:group with 0.16T magnetic disk treated(0.16Tgroup);group with 0.32T magnetic disk treated(0.32Tgroup);control group.General wounds healing situation was observated on the third sixth ninth twelfth day ;The erea of every wound was calculated;Every granulation tissue sample was observated by tissue-pathology.The tissue of granulation was dyeing by immune tissue chemical decoration method,in which VEGF protein content with its range in tissue was measured.Results:General observation showed:There were more oozed thing and granulation in the wounds of 0.16T group and 0.32T group than in that of control group during the course of wound healing.Epithelium cell emerged more early in magnetic group than in control group. The healing time of magnetic group was shorter than of control group.Contrast 0.32T group to 0.16T group,there were more oozed thing and granulation in the wounds.The healing index of magnetic group wounds were larger than that of control group on 3rd,6th,9th and 12th day. The healing index of 0.32T group wounds were larger than that of 0.16T group wounds.Observation of histology indicated:There were more micrangium and fibroblast in magnetic group wounds than that in control group wounds during early time.In the 0.32T group were there the most micrangium and fibroblast.It was more obviously during the middle time.There were lesser micrangium and fibroblast in magnetic group on 12th day than that on 9th day.And more collagen fibers emerged. Epithelium tissue crawled obviously.It was almost closed.The amount of micrangium and fibroblast were more in magnetic group wounds than that in control group wounds.The difference has statistical significance.It was also between 0.32T group and 0.16T group.Observation of VEGF at the course of wound healing:The expressing of VEGF in magnetic group wounds on 3rd and 6th was stronger than in control group wounds.The difference between them has statistical significance.While there were no obvious difference between them on 9th and 12th day(P>0.05).The expressing of VEGF in 0.32T group on 3rd and 6th day was stronger than in 0.16T group. The difference between them has statistical significance.The expressing strength of VEGF in magnetic group reached the peak amplitude on the 6th day.That in control group reached peak amplitude on 9th day.And the peak amplitude of magnetic group was stronger than that of control group.Conclusion:1、Static magnetic disc of 0.16T and 0.32T can promote deep woundof SD rats heal.2、The mechanism of static magnetic field promoting wound heal maybe relative to the expressing highly of VEGF during early and middle time.3、The expressing of VEGF in 0.32T group wounds during early andmiddle time was stronger than that in 0.16T group wounds.lt may be because that the strong magnetic field promote directional migration of fibroblast and vascular endothelial cell quickly.更多还原