放射性核素~(90)Sr防治瘢痕的研究

目的　探讨放射性核素90 Sr对人体增生性瘢痕和猪伤口愈合模型超微结构的影响 ,寻找应用90 Sr治疗瘢痕的最佳时间及有效剂量 ,为其临床应用提供形态学基础。方法　采用放射性核素90 Sr敷贴器 ,用 2 0 0～ 80 0cGy和 2 0 0～ 4 0 0 0cGy分别照射临床诊断为增生性瘢痕者的瘢痕和猪创伤愈合模型 ,用透射电镜观察成纤维细胞超微结构的变化。结果　与对照组相比较 ,小中剂量 (2 0 0～ 6 0 0cGy)90Sr显著促进伤口毛细血管和成纤维细胞增生 ,细胞功能活跃 ,胶原纤维排列致密 ;大剂量 (80 0～ 2 0 0 0cGy) 90Sr照射能显著抑制成纤维细胞增生 ,胶原纤维排列稀疏。结论　临床上可在伤后早期 (约 2～ 3d)用小中剂量90 Sr照射 ,以促进伤口愈合 ;愈合良好的伤口 ,用大剂量90 Sr照射可防止瘢痕增生 ;治疗陈旧性、增生性瘢痕或瘢痕疙瘩 ,90 Sr剂量应为 10 0 0～ 2 0 0 0cGy ;手术前90 Sr照射瘢痕无价值 ,而术后配合大剂量90 Sr照射才是防止瘢痕过度增生的有效方法

Application of radionuclide ~(90)Sr in prevention and treatment of skin scar

Objective To study the ultrastructural changes of hypertrophic scars and animal wound healing models induced by radionuclide 90 Sr exposure and to get the most effective dosage and time in the prevention and treatment of scars. Methods The clinical hypertrophic scars and animal wound models were exposed using 90 Sr applicator in this study. The exposure doses were 200 800 cGy and 200 4 000 cGy. Then the fibroblastic ultrastructure of the tissues from the experimental and control groups were observed with transmission electron microscope. Results Compared with the control groups, capillaries and fibroblasts obviously increased in small and medium doses (200 600 cGy) groups and fibroblastic function was activated. The fibroblasts decreased and fibroblastic function was inhibited in large dose (800 2 000 cGy) groups. Conclusions Small and medium dose of 90 Sr can accelerate wound healing, and can therefore be used in the treatment of early wounds (2 3 days after wounded) ; large dose of 90 Sr can prevent scars from hyperplasia, and can be used in the wounds of the first week after operation; 1 000 2 000 cGy 90 Sr can cure the old hypertrophic scars or keloids; It is useless that 90 Sr exposes before operation for prevention of scars.The most effective method to prevent scars from hyperplasia is large dose of 90 Sr exposure after operation.