摘要目的 观察采用生理盐水、曲安奈德、手术、电子线照射等治疗对兔耳增生性瘢痕的形态学影响,探寻治疗瘢痕的最优方案.方法 建立兔耳腹侧增生性瘢痕模型.随机分为空白组(A组)、生理盐水组(B组)、手术加生理盐水组(C组)、曲安奈德组(D组)、手术加曲安奈德组(E组)、电子线组(F组)、手术后2d电子线组(G组)、手术后7d电子线组(H组),通过HE染色、VG染色、甲苯胺蓝染色、CD34和α-SMA免疫组织化学行组织形态学观察.结果 胶原纤维观察显示:A、B组,D、G组,F、H组差异无统计学意义(P＞0.05),其余各组两两比较差异有统计学意义(P＜0.05).甲苯胺蓝染色发现肥大细胞不典型.微血管观察显示:A、B组,F、H组,G、H组差异无统计学意义(P＞0.05),其余各组两两比较差异有统计学意义(P＜0.05).成肌纤维细胞观察显示:A、B组差异无统计学意义(P＞0.05),其余各组两两比较差异有统计学意义(P＜0.05).结论 曲安奈德注射治疗兔耳瘢痕效果优于电子线放疗,电子线术后早期放疗效果优于愈合后放疗,曲安奈德、电子线联合手术治疗效果优于单一治疗.

abstractsObjective To observe the morphological changes by different electron beam radiation methods and different triamcinolone acetonide treatments on the role of hypertrophic scar of rabbit ear,and to explore the optimal treatment for the rabbit ear scar.Methods The ventral rabbit ear hypertrophic scar model was established,and intervention began at 28 days after surgery.The animals were randomly divided into control group (group A),saline group (group B),surgery plus saline group (group C),triamcinolone acetonide group (group D),surgery plus triamcinolone group (group E),and electron beam group (group F),2 days after surgical electron beam group (group G),and 7 days after surgical electron beam group (group H).HE stain,VG stain,toluidine blue stain,CD34 and Alpha-SMA immunohistochemical staining were performed,and comparied on histomorphology of each group.Results Collagen fibers observed showed that there was no statistically significance between groups A and B,groups D and G and groups F and H (P＞0.05),and the difference was statistically significant between other groups (P＜0.05).Mast cells were not typical by toluidine blue staining.The microvascular observation showed there was no statistically significance between groups A and B,groups F and H,and groups G and H (P＞0.05),and the difference was statistically significant between other groups (P＜0.05).Myofibroblasts showed no statistically significance between the groups A and B (P＞0.05),but the difference was statistically significant between other groups (P＜0.05).Conclusions Compared with electron beam radiation methods,triamcinolone acetonide injection is a better treatment.Early postoperative radiotherapy is better than late.Triamcinolone acetonide or electron beam radiation combined with surgery is better than simple treatment.