确炎舒松对扩张囊包膜组织学及扩张过程的影响

Effect of triamcinolone on the histopathology of fibrous capsule expanded and expansion procedure

目的 探讨确炎舒松对扩张纤维囊组织结构及扩张过程的影响及其机制。方法 对 2 4例成年患者按部位随机分为用药组和对照组 ,用药组于扩张器置入后 1周向扩张囊外周注入确炎舒松 (悬液 ) 2 0～ 40mg。两组同时开始扩张 ,注水间隔均为 48h ,每次注水均使扩张器表面皮肤变韧。记录每例达到 5 0 %和完成扩张容量的时间 (天 ) ,第二次手术时切取纤维包膜及皮瓣进行组织学观察。结果 用药组达到 5 0 %和 10 0 %容量所需时间分别为 (10± 3)天和 (2 4±4)天 ,对照组分别为 (14± 3 5 )天和 (40± 5 )天 ,两组对比差异有显著性 (P <0 0 5和P <0 0 1)。组织学观察 :纤维包膜均分肉芽层和胶原纤维层 ,用药组两层均较薄 ,肉芽层炎细胞数目少 ,血管少且细 ,纤维层胶原稀疏、薄 ,仅有少量成肌纤维细胞 ;对照组则相反。两组真皮均变薄 ,未见有纤维断裂现象。结论 扩张术后早期局部应用确炎舒松可有效控制扩张纤维囊增生 ,加快扩张速率 。

Objective To explore the effect and mechanism of triamcinolone on the tissue of fibrous capsule expanded and expansion procedure. Methods 24 adult cases were equally divided into two groups.For the group given the drug,triamcinolone about 20～40 mg were delivered to the local tissue around the expander a week after the first operation. Two groups were expanded in the same injection interval in 48 hours. The time to reach the middle and full expantion volume was recorded. The fibrous capsule tissues were observed histologically when the second operation was taken. Results The mean time to reach the half and full expansion volume of the experimental group was(10±3) days and (24±4) days, and the time at the control group (14±3 5) days and (40±5) days ( P <0 05 and P <0 01) . The observation of histopathology on fibrouscapsule proved the significant difference between the two groups. Conclusion The introduction of triamicinolone around the expander can restrict the formation of fibrous capsule and speed up the expansion procedure.This method is a safe,rapid and effective soft tissue expansion.