超声辐照兔外阴皮肤的病理学转归

Pathologic Changes of Vulva Skin of Rabbits After Ultrasound Irradiation

目的:探讨超声治疗外阴白色病变的机制。方法:实验兔随机分成辐照组4组(每组10只)及对照组(10只)。辐照组以CZF-1超声治疗仪样机对兔外阴皮肤真皮层进行连续直线辐照,功率4W,4组分别于辐照后1、4、7和14天取材,对照组不辐照立即取材。作光镜、电镜检查。结果:超声辐照后第1天外阴充血水肿,皮肤完整,稍硬,增厚感,皮温升高。第4天外阴充血水肿消失,仍然稍硬,皮温正常。第7天后外阴外观正常,皮肤色泽及质地同辐照前。组织学变化:超声辐照后第1天,表皮完好,真皮乳头层水肿,轻度充血。第4天充血水肿消退,可有慢性炎性细胞浸润。第7天后可见新生毛细血管增生。第14天与正常外阴皮肤一致。超微结构变化:第1、4、7天可见血管内皮细胞线粒体肿胀、微吞饮小泡数量多,成纤维细胞线粒体肿胀、粗面内质网扩张,神经纤维内线粒体肿胀。结论:提示超声有利于微血管、胶原纤维和神经末梢的增生与修复。推测超声用于外阴白色病变临床治疗是有效和安全的。

Objective： To investigate therapy mechanism of white lesions of vulva by ultrasound. Methods： We divide 50 rabbits into 5 equal groups （4 irradiation groups and 1 control group）, irradiating vulva dermis in irradiation groups with CZF - 1 ultrasound therapy model machine, irradiation power 4W. We take samples on 1, 4, 7 and 14 days after irradiation. Results： There are hyperemia and edema at irradiation area 1 day later, epidermis is complete and a little rigid, skin temperature is higher than normal skin. After 4 days, there are no hyperemia and edema, a little rigid epidermis and normal skin temperature. Vulva skin show normal 7 days later. Microscopic changes： edema and gentle hyperemia exist in papillary layer of dermis 1 day later. Hyperemia and edema disappear 4 days later, chronic inflammatory cell may exist. Hypertrophy of capillary vessel appears 7 days later. The skin resume totally 14 days later. Electron microscopic changes： 1, 4 and 7 days after ultrasound irradiation, endothelial cell of blood vessel exist mitochondria swelling and more micropinocytotic vesicle, fibroblast have mitochondria swelling and rough endoplasmic reticulum dilatation, nerve fibre also exist mitochondfia swelling. Conclusion ： These results suggest ultrasound is in favor of hypertrophy and rehabilitation of microvasculature, collagen fihrils and nerve ending. We presume that it is effective and safe to use ultrasound to treat white lesions of vulva.