小型猪皮肤压疮模型的建立及其皮肤病理分析

Establishment of skin pressure ulcer model in miniature pigs and the pathological analysis

目的：通过自制压力模具，观察不同压力和受压时间对小型猪皮肤的影响，为早期皮肤压疮制作适宜的动物模型。方法5～6个月龄的小型猪4头，雄性，体重35～40 kg。于脊柱两侧旁4 cm处做与身体长轴垂直的长约5 cm的皮肤切口，深达肌层，向切口两侧钝性分离组织，依次放入自制压力可调节模具，每头猪背部8个受压创面，共32个创面，将所有创面随机分到0、5、10、15、20 kg组，其中根据受压时间的不同，0 kg组又分为0 kg／12 h、0 kg／24 h亚组，5 kg组分为5 kg／12 h、5 kg／24 h亚组，10 kg分为10 kg／2 h、10 kg／6 h、10 kg／12 h、10 kg／24 h亚组，15 kg分为15 kg／2 h、15 kg／6 h、15 kg／12 h、15 kg／24 h亚组，20 kg分为20 kg／2 h、20 kg／6 h、20 kg／12 h、20 kg／24 h亚组，共计16个亚组，每亚组2个创面。制作小型猪压疮模型，观察创面大体情况，并于不同受压时间点后取受压组织进行苏木精-伊红（ HE）染色，光镜下对受压部位皮肤组织进行观察。结果除0 kg组去除受压装置后受压皮肤与正常皮肤组织相似，光镜下观察未见异常外，其余组均有不同程度损伤。肉眼观，去除压力模具后，受压组织均存在不同程度红色或发白，皮肤呈现淤血或红斑，其中20 kg组颜色变化最明显；光学显微镜下典型表现为胶原纤维断裂或坏死、脂肪细胞坏死、血管内充血或破裂出血。结论使用该压力装置能够模拟压疮的临床及病理组织学表现，能够成功制作小型猪早期压疮模型。

Objective To observe the effects of different magnitudes of pressure and time on the skin of miniature pig , and make a suitable animal model for skin pressure ulcer .Methods Four miniature pigs, male, 5-6 months old, and 35-40 kg weight.The 5 cm skin incision perpendicular to the long axis of back was made on both sides of spine .A self-made pressure mode was placed beneath the incision after blunt dissection .There were 8 wounds on each miniature pig and a total of 32 wounds which were randomly divided into group 0 kg/12 h, 0 kg/24 h, 5 kg/12 h, 5 kg/24 h, 10 kg/2 h, 10 kg/6 h, 10 kg/12 h, 10 kg/24 h, 15 kg/2 h, 15 kg/6 h, 15 kg/12 h, 15 kg/24 h, 20 kg/2 h, 20 kg/6 h, 20 kg/12 h, 20 kg/24 h, with 2 wounds in each group.The general situation and histological analysis were observed.Results Except that skin under pressure was similar to the normal skin tissue and no abnormality was found microscopically in group 0 kg, skin in other groups had varying degrees of damage .Compressed skin appeared red or white color with congestion or erythema, in which the color change was most obvious in group 20 kg.In light microscope, the typical manifestation included collagen fiber breakage or necrosis, fat cell necrosis, congestion or bleeding in blood vessel.Conclusion This self-made pressure mode could mimic the clinical and pathological manifestations of pressure ulcer and make miniature pig model of early stage skin pressure ulcers .