摘要
背景:近年来,同种异体脱细胞真皮基质组织补片已在口腔组织缺损修复中广泛应用,但有关异种脱细胞真皮基质组织补片修复口腔黏膜缺损的研究较少。目的:评价异种脱细胞真皮基质在口腔黏膜组织缺损修复中的效果及生物安全性。方法:选择口腔良、恶性肿瘤手术切除后遗留的黏膜及部分软组织缺损患者71例,男37例,女34例,年龄45(20～70)岁;其中良性肿瘤42例,恶性肿瘤29例。采用异种脱细胞真皮基质组织补片修复口腔软组织浅层缺损。观察生物膜成活情况,颜色、质地,比较组织补片修复无硬组织支撑部位(颊、舌、口底)和有硬组织支撑部位(牙龈、硬腭)的收缩率。结果与结论:71例补片完全成活,未发生坏死、感染等并发症。植入后2周补片成活面积为(98.20±5.20)%,植入后3个月,补片颜色已与周围黏膜相近,大部分患者诉有不同程度的紧张感;植入后6个月补片植入区成功完成了细胞的爬行代替和血管化,生长稳定,无进一步收缩,弹性良好,患者感觉趋于正常。生物膜收缩发生在植入后2周～1个月,植入后3个月后基本稳定,术区组织形态与正常组织相比无明显差异。无硬组织支撑部位(颊、舌、口底)的收缩率较硬组织支撑部位(牙龈、硬腭)收缩率大。说明应用异种脱细胞真皮基质组织补片修复口腔黏膜具有组织相容性好、来源广泛、操作简单等优点,能够起到早期覆盖创面,促进创面愈合,减轻瘢痕生成的作用,可作为口腔黏膜缺损修复的理想材料。
BACKGROUND：Recently,acellular dermal matrix allograft has been widely used in the repair of oral mucosal defects.But little information is about the heterogeneous acellular dermal matrix（HADM）patch for repair of oral mucosal defects.OBJECTIVE：To investigate the efficacy and biosafety of HADM in the repair of oral mucosal defects.METHODS：In total 71 patients with oral benign or malignant tumors who had oral mucosal or soft tissue defects following tumorectomy were included in this study.These patients comprised 37 males and 34 females,and were averaged 45 years（range,20-70 years old）.Of them,42 suffered from benign tumors and 29 from malignant tumors.HADM patches were used for repair of oral mucosal defects.The survival,color,and texture of HADM patches were observed.Shrinkage rate of HADM patches was compared between regions without supports from hard tissues（cheeks,tongue,and mouth floor）and with supports from hard tissues（gingiva,hard palate）.RESULTS AND CONCLUSION：All 71 HADM completely survived.No necrosis and infection occurred.At 2 weeks after transplantation,（98.20±5.20）% of patch area survived.At 3 months after transplantation,patches showed similar color to surrounding oral mucosa and most patients had sense of tension to different extents.At 6 months after transplantation,cell creeping substitution and vascularization were successfully accomplished in the region of patch transplantation.Patches grew stably,with smooth pink appearance and good elasticity,and no further shrinkage.Patients felt normal.HADM patch shrank primarily at 2 weeks-1 month after transplantation,and tended to be stable at 3 months.There was no significant difference in tissue morphology between surgical region and normal tissue.The HADM shrinkage rate was significantly higher in regions without supports from hard tissues than regions with supports from hard tissues.These findings indicate that HADM patches have advantages in repair of oral mucosal defects including good histocompatibility,wide source,simple manipulation,and able to cover the wound surface in the early state,promote wound surface healing,and reduce scar formation,and can be used as an ideal material for repair of oral mucosal defects.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第16期3015-3018,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
