中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (7): 1315-1318.doi: 10.3969/j.issn.1673-8225.2012.07.041

• 组织构建学术探讨 tissue construction academic discussion • 上一篇    下一篇

与整形修复重建外科相关的血管生物学研究及进展★

林  艳1，王建华2，吴东方3   

  1. 1张家口教育学院护理学院，河北省张家口市 075000；2解放军第251医院，河北省张家口市 075000；3解放军南京军区福州总医院整形外科，福建省福州市 350525
  • 收稿日期:2011-11-01 修回日期:2011-11-14 出版日期:2012-02-12 发布日期:2012-02-12
  • 通讯作者: 吴东方，硕士，副主任医师，硕士生导师，解放军南京军区福州总医院整形外科，福建省福州市 350525 micheal.justin@ymail.com
  • 作者简介:林艳★，女，1981年生，河北医科大学在读硕士，助教。 letter625613@163.com

Vascular biology research related to the reconstructive surgery and its development

Lin Yan1, Wang Jian-hua2, Wu Dong-fang3   

  1. 1Nursing Department, Education College of Zhangjiakou, Zhangjiakou  350525, Hebei Province, China; 2the 251 Hospital of Chinese PLA, Zhangjiakou  075000, Hebei Province, China; 3Department of Plastic Surgery, Fuzhou General Hospital of Nanjing Military Region, Fuzhou  350525, Fujian Province, China
  • Received:2011-11-01 Revised:2011-11-14 Online:2012-02-12 Published:2012-02-12
  • Contact: Wu Dong-fang, Master, Associate chief physician, Master’s supervisor, Department of Plastic Surgery, Fuzhou General Hospital of Nanjing Military Region, Fuzhou 350525, Fujian Province, China micheal.justin@ymail.com
  • About author:Lin Yan★, Studying for master’s degree, Teaching assistant, Nursing Department, Education College of Zhangjiakou, Zhangjiakou 350525, Hebei Province, China letter625613@163.com

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摘要：

背景：组织缺损皮瓣修复时，当皮瓣的切取面积太大，常会遇到程度不等的坏死。为了解决此问题，研究者致力于血管新生最重要的2个途径——内皮细胞型血管新生及祖细胞型血管新生进行研究，希望由此来促进皮瓣存活及培育人工血管。
目的：对组织瓣的微血管生理学、缺血损伤后的血管再生及与组织缺损重建相关的组织工程进行综述，总结目前血管生物学的研究进展程度，展望其应用前景。
方法：由作者通过计算机检索PubMed数据库，检索词为“flap，reconstructive surgery，vascular physiology，choke vessels，angiogenesis，vasculogenesis，tissue engineering”。阅读分析相关文献后，作者从皮瓣的演变史及存活机制、血管新生的主要途径及其分子水平的调控机制和血管新生在组织工程学中应用的研究进展进行总结介绍。共检索到69篇文章，按照纳入与排除标准对文献进行筛选，共纳入30篇文章。
结果与结论：皮瓣坏死常发生在闭塞性血管所在的位置；血管新生对于皮瓣的成活至关重要，而血管新生最主要的2条的途径是“内皮型血管新生”及“祖细胞型血管新生”；为了更好的利用组织工程来解决组织缺损的问题必须解决好带血供组织工程的细胞来源与支架设计问题。目前，如何更好的在分子水平来调控血管新生来促进皮瓣存活及更有效的培育带血供的工程组织还有巨大的研究前景。

关键词: 血管新生, 血管生理, 闭塞性血管, 皮瓣, 整形, 修复, 重建, 组织构建

Abstract:

BACKGROUND: After years of development, a variety of flaps are now available in clinic for defect reconstruction. But problems exist that when a large flap is harvested, a varying degree of necrosis often occurs. In order to solve this problem, researchers and clinicians focus on study of two main pathways for neovascularization: angiogenesis and vasculogenesis, with the hope that deeper research in neovascularization can be manipulated to improve flap survival and culture of engineering vessels.
OBJECTIVE: To provide a comprehensive review on three aspects: the microvascular physiology, the neovascularization after ischemia and injury, and tissue engineering related to defect reconstruction. To summarize the progression of vascular biology research and its using prospect.
METHODS: The first author retrieved literatures from PubMed database with the index words of “flap, reconstructive surgery, vascular physiology, choke vessels, angiogenesis, vasculogenesis, tissue engineering” in English. After reading and analysis of the literature of interest, the flap development history and survival mechanism, the patterns of neovascularization, and its regulating mechanism at the molecular level, and the role of neovascularization in tissue engineering were summarized and presented in this article. A total of 69 articles were retrieved, and after screening according to the inclusion and exclusion criteria, 30 articles were elaborately studied and the viewpoints extracted.
RESULTS AND CONCLUSION: The results showed that necrosis of the flap often occurs at the choke zone, and neovascularization whose two main pathways were angiogenesis and vasculogenesis showed great importance to flap survival. Scaffolds design and cell sources were two vital problems for development of tissue engineering aimed for defect reconstruction. Now, how to manipulate the neovascularization at the molecular level to improve flap survival and culture vascularized engineering tissue in a more efficient way was still a huge field yet to be explored.

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