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点阵CO2激光联合MEBO瘢痕再生皮肤疗法的组织学研究报告
Histological Study in the Regeneration of Scarred Skin Treated with Fractional CO2 Laser-MEBO Combined Therapy

谭军.点阵CO2激光联合MEBO瘢痕再生皮肤疗法的组织学研究报告[J].中国烧伤创疡杂志,2012,24(4):271~283.

DOI：10.3969/j.issn.1001-0726.2012.4.002

英文关键词:Fractional CO2 laser MEBO Scar Efficacy

基金项目:

作者	单位
谭军	湖南省人民医院整形激光美容科

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中文摘要:

目的　观察点阵CO2激光联合MEBO 治疗瘢痕皮肤的临床疗效并总结临床经验。方法　1) 动物实验: 利用点阵CO2 激光治疗兔耳瘢痕模型后, 创面分别采用MEBO与四环素眼药膏治疗, 对比观察创面愈合过程,用药过程中活检皮肤组织, 经HE染色, 观察皮肤各层组织结构的变化, 通过免疫组化方法检测K-19和P63的表达, 观察瘢痕愈合过程中的组织学变化; 2) 临床应用: 经点阵CO2激光联合MEBO 治疗后24 h、4 d、7 d、14 d 进行P63 的组织化学染色, 观察创面变化。结果　MEBO 治疗后创面愈合过程表现为再生复原程序, 上皮组织增殖分化, 结缔组织重新分布, 形成明显的基底膜, 治疗后第7 天创面再生出新的组织, 真皮层组织结构接近于生理性组织结构, 从而使瘢痕组织再生为生理性皮肤组织; 四环素眼膏治疗后创面愈合过程表现为创伤愈合程序, 上皮组织与结缔组织杂乱增生, 未生成基底膜, 真皮层依然是纤维化组织, 不能使瘢痕组织再生为生理性皮肤组织。结论　点阵CO2激光联合MEBO 治疗瘢痕皮肤疗效确切, 安全性高, 无不良反应, 值得临床推广应用。

英文摘要:

Objective　To observe the clinical efficacy of the fractional CO2 laser-MEBO combined therapy in treating scarred skin and summarize the clinical experience. Methods　1) Animal experiments: The scarred skin model of rabbit ear was firstly treated with fractional CO2 laser, and the resulting wounds were respectively treated with MEBO and tetracycline eye ointment. And the healing processes were observed and compared. During the treatment, perform the skin tissue biopsy to observe the histological changes under the immunohistochemical microscope after the HE staining, K-19 labeling and P63 labeling;2) Clinical application:24hours、4days、7days、14days after the fractional laser-MEBO combined therapy, perform P63 histochemical staining to observe the changes on the wounds. Results　The wound managed with MEBO showed the regenerative restoration. Epithelial tissues proliferated and differentiated together with the redistribution of connective tissues forming clear basement membranes. After a consecutive 7 days of treatment, there were new tissues regenerated, the tissue structure in the dermal layer is almost the same as the physiological normal one, and eventually, the scarred tissues regeneratedinto their physiological counterparts. In contrast, the wound managed with tetracycline ointment showed the process of wound healing. The epithelial and connective tissues proliferated in a disorder way with no formation of basement membrane. The dermal layer was still composed of fibrotic tissues incapable of transforming the scarred tissues into physiological normal tissues.Conclusion　The efficacy of fractional CO2 laser combined with MEBO in treating scarred skin is definite and safe without adverse reactions, and it deserves to be promoted in clinic.