文献类型：期刊文献

中文题名：皮瓣缺血再灌注损伤的发病机制及治疗进展

英文题名：Pathogenesis and treatment progress of flap ischemia-reperfusion injury

作者：何波[1];陈文[2];马岁录[3];何志军[2];宋渊[2];李金鹏[2];刘涛[2];魏晓涛[4];王威威[4];谢婧[4]

第一作者：何波

机构：[1]南阳市中医院,河南省南阳市473007;[2]甘肃省中医院,甘肃省兰州市730050;[3]西安市中医院,陕西省西安市710000;[4]甘肃中医药大学,甘肃省兰州市730030

第一机构：南阳市中医院,河南省南阳市473007

年份：2025

卷号：29

期号：6

起止页码：1230

中文期刊名：中国组织工程研究

外文期刊名：Chinese Journal of Tissue Engineering Research

收录：CSTPCD;;Scopus;北大核心:【北大核心2023】；

基金：国家自然科学基金项目(81660802),项目负责人:何志军;国家自然科学基金项目(81660803),项目负责人:宋渊;甘肃省中医药项目(GZKZ-2020-2),项目负责人:何志军。

语种：中文

中文关键词：皮瓣;缺血再灌注损伤;炎症反应;氧化应激反应;Ca^(2+)超载;细胞凋亡;间充质干细胞;富血小板血浆;信号通路;冲击波;预处理

外文关键词：flap;ischemia-reperfusion injury;inflammatory response;oxidative stress;Ca^(2+)overload;apoptosis;mesenchymal stem cell;platelet-rich plasma;signaling pathway;shock wave;pretreatment

摘要：背景:皮瓣移植技术是治疗严重组织缺损的常用外科手术方式,但术后因缺血再灌注损伤容易引发皮瓣坏死,因此提高移植皮瓣的存活率仍是目前重要的研究课题。目的:综述皮瓣缺血再灌注损伤的发病机制及最新治疗进展。方法:检索CNKI、万方和PubMed数据库中2014-2024年发表的相关文献,中文检索词为“皮瓣,缺血再灌注损伤,炎症反应,氧化应激反应,Ca^(2+)超载,细胞凋亡,间充质干细胞,富血小板血浆,信号通路,冲击波,预处理”,英文检索词为“flap,ischemia-reperfusion injury,inflammatory response,oxidative stress,Ca^(2+)overload,apoptosis,mesenchymal stem cells,platelet-rich plasma,signaling pathways,Shock wave,Pretreatment”。通过阅读文章剔除研究内容与文章主题关系不大、质量较差及内容陈旧文献,最终纳入77篇文献进行归纳总结。结果与结论:皮瓣缺血再灌注损伤损伤可能与炎症反应、氧化应激反应、Ca^(2+)超载、细胞凋亡等病理因素有关,引起皮瓣血管内皮细胞凋亡、血管损伤和微循环障碍,最终导致皮瓣坏死。研究发现,间充质干细胞移植、富血小板血浆、信号通路调节剂、冲击波及预处理等治疗方法均可以从不同方向在不同程度上缓解皮瓣缺血再灌注损伤,降低移植皮瓣的坏死率和坏死面积。关于皮瓣缺血再灌注损伤的治疗方法虽然很多,然而临床还未形成统一有效的治疗方法,各种治疗方法的优缺点也未进行对比研究,并且大部分研究都停留在动物实验阶段,临床观察研究甚少,因此未来还需要进行大量研究,逐步由动物实验向临床迈进,以便更好地为临床服务。
BACKGROUND:Flap transplantation technique is a commonly used surgical procedure for the treatment of severe tissue defects,but postoperative flap necrosis is easily triggered by ischemia-reperfusion injury.Therefore,it is still an important research topic to improve the survival rate of transplanted flaps.OBJECTIVE:To review the pathogenesis and latest treatment progress of flap ischemia-reperfusion injury.METHODS:CNKI,WanFang Database and PubMed database were searched for relevant literature published from 2014 to 2024.The search terms used were“flap,ischemia-reperfusion injury,inflammatory response,oxidative stress,Ca^(2+)overload,apoptosis,mesenchymal stem cells,platelet-rich plasma,signaling pathways,shock wave,pretreatment”in Chinese and English.After elimination of irrelevant literature,poor quality and obsolete literature,77 documents were finally included for review.RESULTS AND CONCLUSION:Flap ischemia/reperfusion injury may be related to pathological factors such as inflammatory response,oxidative stress response,Ca^(2+)overload,and apoptosis,which can cause apoptosis of vascular endothelial cells,vascular damage and microcirculation disorders in the flap,and eventually lead to flap necrosis.Studies have found that mesenchymal stem cell transplantation,platelet-rich plasma,signaling pathway modulators,shock waves,and pretreatment can alleviate flap ischemia/reperfusion injuries from different aspects and to varying degrees,and reduce the necrosis rate and necrosis area of the grafted flap.Although there are many therapeutic methods for skin flap ischemia/reperfusion injury,a unified and effective therapeutic method has not yet been developed in the clinic,and the advantages and disadvantages of various therapeutic methods have not yet been compared.Most of the studies remain in the stage of animal experiments,rarely involving clinical observations.Therefore,a lot of research is required in the future to gradually move from animal experiments to the clinic in order to better serve the clinic.