Chinese Journal of Tissue Engineering Research ›› 2018, Vol. 22 ›› Issue (6): 877-882.doi: 10.3969/j.issn.2095-4344.0062
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Received:
2017-09-14
Online:
2018-02-28
Published:
2018-02-28
Contact:
Zhong Sheng, Master, Attending physician, Department of Hands and Feet Microsurgery, Dalian Municipal Central Hospital, Dalian 116033, Liaoning Province, China
About author:
Zhang Tie-hui, Chief physician, Professor, Department of Hands and Feet Microsurgery, Dalian Municipal Central Hospital, Dalian 116033, Liaoning Province, China
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CLC Number:
Zhang Tie-hui, Liang Wu, Ren Yuan-fei, Dong Yu-jin, Yang Wen-feng, Shang Yao-hua, Li Ju-tao, Zhong Sheng. Application of microsutures with vascular endothelial growth factor to improve vascular endothelial regeneration after small vessel anastomosis in the rats[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(6): 877-882.
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2.1 检测血管内皮因子缓释微粒大小 激光粒度分析仪测量测试15份微粒的粒径范围为83-121 nm,平均粒径为(104.25±17.03)nm。其中1份样本测量直径为53.27 μm,考虑原因为多个微粒聚合而成,予以排除该样本。 2.2 微粒中血管内皮因子的体外释放检测 孵育1 d时,微粒中的血管内皮生长因子释放量为15.54%,表现为爆发性释放,随后释放速度有所减慢,在第5天后又有一个快速释放期,但速度小于第一个快速释放期,第8天以后呈持续缓慢释放,第13天开始每日释放量明显减少并波动不大,第20天开始无明显释放量,后连续监测10 d 维持于43.71%,连续监测30 d最大累积值为43.71%(图2)。"
2.3 实验动物数量分析 90只大鼠均造模成功,其中4只在实验过程中死于建模后感染,予以剔除,并补充重新制作动物模型,最终90只大鼠进入结果分析。 2.4 两组大鼠术后尾部大体观察分析 正常大鼠鼠尾颜色红润,皮温暖,活动度良好。血管吻合后,若血管再通正常表现大鼠颜色、温度没有变化。实验组大鼠共有8只发生术后并发症:术后2 h,仅有5只鼠尾发生动脉缺血表现,鼠尾远端苍白,皮温凉;术后3 d,有3只鼠尾发生动脉缺血表现;至术后7 d时,上述8只鼠尾中,6只部分坏死,2只未见明显坏死,但皮温始终较正常凉。对照组大鼠共有21只发生术后并发症:术后2 h,16只动脉缺血表现;术后3 d时,新添5只发生动脉缺血表现;至术后7 d时,上述鼠尾完全坏死12只,部分坏死8只,1只未见明显坏死,但皮温始终较正常凉。实验组术后并发症发生率明显小于对照组(P < 0.05),病情程度也明显轻于对照组,见图3、表1。"
2.5 两组大鼠术后小动脉内皮细胞变化情况 ①对照组:血管吻合术后1 d,内皮细胞肿胀,部分脱落,内皮下层呈细胞浸润及创伤性增生反应,内弹性膜层消失,平滑肌细胞发生变性坏死,外膜层细胞浸润并呈创伤性增生反应;术后3 d,内皮细胞脱落区出现新生内皮细胞并出现生长移行,使吻合口开始有内皮细胞覆盖;术后5-7 d,新生的内皮细胞爬过吻合口裂隙并覆盖缝线;②实验组:血管吻合术后1 d,吻合口缝线附近可见增生的内皮细胞。术后3 d,小血管吻合口两端缝线附近可见大量增生的内皮细胞和内皮下组织并向管腔突出,形成突起,并完成覆盖缝线;术后7 d,内皮细胞及内弹性膜修复完全恢复正常,平滑肌细胞进一步增生,外膜恢复正常,实验组小血管内皮增生时间明显早于对照组,增生强度明显好于对照组(图4)。"
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