放射损伤对创面愈合的影响

Effects of radiation injury on wound healing

放射损伤合并创伤称为“放创复合伤”,主要见于核爆炸、核事故和核恐怖活动,也可见于临床放疗等病例,其中创面或伤口愈合显著延缓是一个突出的医学问题。电离辐射延缓创面愈合的机制是“以细胞损害为关键环节的愈合诸因素调控失调”,其中“细胞”同时包括造血细胞和修复细胞,而“损害”则同时包括数量和功能的损害。对放创复合伤创面促愈的一个重要原则是要同时考虑增加创伤局部造血细胞和修复细胞的数量,促进其功能。已经筛选获得了数种对放创复合伤具有促愈作用的药物和生长因子。

Combined radiation and wound injury (CRWI) often occurs under the conditions of nuclear explosions, severe nuclear accidents, radiological terrorism and radiotherapy accidents. A prominent medical problem is that this kind of skin wound is very complex and difficult to heal. The quantity and function damage of cellular components in the wound sites including hematopoietic cells and repairing cells plays key roles in the healing delay process. For the treatment of CRWI, promoting wound healing and the hematopoietic recovery should be considered simultaneously. Several chemical or natural drugs and growth factors have shown promoting effects on the wound healing in CRWI. Application of adult multipotent stem cells may provide a new promising way for the management of CRWI.