發光二極體刺激對豬燒傷傷口癒合之影響

The Effect of Burn Wound Healing by Light-Emitting Diode Stimulation in A Pig Model

楊智超(Chih-Chao Yang)

指導教授 ： 謝瑞香

中原大學/工學院/醫學工程研究所/碩士(2005年)

https://doi.org/10.6840/cycu200500790

摘要

中文摘要

本研究主要探討紅光發光二極體(light-emitting diode, LED) 對傷口癒合的影響。我們選用三～五個月大的三品系豬（Landrace-Yorkshire-Duroc）作為本研究之實驗動物。以劑量為25mg/Kg的肌肉注射式麻醉劑Zoletil®50施打，並以人工呼吸器持續麻醉。以1×1公分的銅器加熱至170℃，接觸左右兩側皮膚20秒以製造燒傷傷口。右側傷口以630nm、20mW/cm2、刺激200秒，而總能量為4J/cm2、間隔一天的刺激參數重複進行光照；左側則為未照光組。並以四個評估方式：（1）傷口面積評估；（2）表皮再生評估；（3）比較不同癒合時期的病理組織再生情形；（4）比較病理組織內的嗜中性球（Polymorphonuclear leukocyte, PMN）、巨噬細胞（Macrophage）、纖維母細胞（Fibroblast）及血管（Vessel）數量，來探討光照對傷口癒合的影響。
本研究結果，發現光照組傷口在第十四天，傷口面積已明顯縮小為52.81±14.9%，而未照光組則為90.15±7.34%。而且發現光照後對於傷口癒合的時間，大約提早24.05±2.23%。
至於表皮再生的評估上，發現在第十三天，光照組的傷口表皮再生已達91.75±11.67mm2，而未照光組僅達到70.25±10.96mm2。
由組織切片上，發現光照組之傷口在第二十一天癒合，而未照光組則到第二十八天才癒合，即光照組較未照光組提前七天癒合。此結果與傷口面積變化的結果相符。
最後，在評估細胞變化的情形上，光照組與未照光組的嗜中性球在第七天達到高峰，但光照組數量為28585.3±1627個，未照光組則為39684±17158個。光照組與未照光組的巨噬細胞，在第十天出現高峰，光照組數量為3231.3±1049個，未照光組則為2664±1346個。光照組的血管數量在第十四天達到高峰，數量為1652.7±242個，但未照光組直到第二十一天才達到高峰，數量則為1750±429個。至於纖維母細胞的個數上，光照組在第十天達到高峰，數量為77766.7±23098個，且在第十四天有大量膠原纖維的產生；而未照光組直到第十四天才達到高峰，數量為87822.7±17121個。另外，嗜中性白血球與巨噬細胞的比值，光照組在第十天是0.74±0.58，而未照光組則為2.43±1.81。
綜合以上結果，光刺激對於巨噬細胞、血管、纖維母細胞具有增生效果。因此，紅光630nm、20mW/cm2、刺激200秒，即總能量為4J/cm2的發光二極體對豬的傷口癒合具有促進的效果。

關鍵字

傷口癒合 ； 發光二極體 ； 燒傷 ； 纖維母細胞

並列摘要

Abstract

We investigated the effect and possible mechanism of red LED irradiation on wound healing. Landrace-Yorkshire-Duroc strand pigs of age 3 to 6 months were used and anesthetized with Zoletil®50(25mg/Kg i.m.). Daily wound treatment was performed under general anesthesia using a halothane, N2O, O2 mixture, without intubation. Copper material of size 1×1cm was heated up to 170℃, and then applied to the both flank for 20 seconds. Twenty contact burn wounds were created (10 on each flank). Red LED (wavelength=630nm, power density=20mW/cm2) was stimulated on right flank with the total irradiation energy of 4J/cm2 for 200 sec, and the frequency was once treatment with an interval day. Left flank was used as non-irradiated area. To evaluate the effect of light treatment on wound healing, there were four estimations: (1)wound area assessment; (2)re-epithelialization assessment; (3)to compare tissue repair of each wound healing time; (4)to compare the number of PMN, macrophage, fibroblast and vessel proliferation in healing tissue.
On PBD14, light-treated wounds were 52.81±14.9%, but untreated wounds were 90.15±7.34%. And light-treated wound healing time was early 24.05±2.23%.
Re-epithelialization of light-treated wound attained to 91.75±11.67mm2, but untreated wound only attained to 70.25±10.96mm2.
Macroscopically the light-treated wound healed on PBD21, but untreated wound healed up to on PBD28. The indication was the healing time of light-treated group could be 7 days more early than untreated group.
The maximum numbers of PMN in both groups were on PBD7 and light-treated group was 28585.3±1627, but untreated group was 39684±17158. Then the macrophage’s were on PBD10 and light-treated group was 3231.3±1049, but untreated group was 2664±1346. The vessel’s of light-treated group were on PBD14 and 1652.7±242, but which of untreated group were up to PBD21 and 1750±429. As to the maximum numbers of fibroblast in light-treated group were PBD10 and 77766.7±23098. Moreover, there were collagen fiber secretion on PBD14; but the peak value of untreated group was up to PBD14 and 87822.7±17121. In addition, the ratio of PMN/macrophage in light-treated group was 0.74±0.58 on PBD10, but untreated group was 2.43±1.81.
As a result, photostimulation can provide proliferation of macrophage, vessel, and fibroblast. Hence, the use of red LED irradiation on burn wounds in a pig model will greatly enhance the wound healing process.

並列關鍵字

burn ； fibroblast ； LED ； wound healing

參考文獻

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