创伤医学教学课件.ppt

The functions of cell in the process of wound healing Neutrophil (中性粒细胞) Macrophage (巨噬细胞) Platelet（血小板） Lymphocyte (淋巴细胞) Inflammatory reaction stage: PDGF,TGF-α,bFGF, MDGF tissue proliferation stage: IGF-1, bFGF ,TGF-β, PDGF scar formation stage: TGF-β, PDGF The functions of growth factor in the process of wound healing Participate in coagulation process Enhance the function of macrophage Chemotaxis (趋化作用) The functions of fibronectin (Fn)  (纤维连接蛋白) repair proliferation mesenchymal tissue fill the deficit 细胞增生 细胞间质充填连接 Process of repair 1）fibrin filling sealing the wound （纤维蛋白充填） Hemostasis（止血） Process of repair 2）proliferation （细胞增生） Fibroblast 成纤维细胞 endothelial cells 内皮细胞 neogenetic vessels 新生血管 granuloma 肉芽肿 process of repair Collagen （胶原） Amino-polysaccharide （氨基多糖） 基质沉着 fibroblasts, endouthelial cells, epithelial cells, osteoblasts fibrous tissue（scar） process of repair 3）tissue plasty Macrophages（巨噬细胞），platelet（血小板）lymphocytes，various mediators (early period) hyperplasia synthesis (late period) decomposition modeling harmful factors for would healing 1 infection 2 foreign bodies or excessive inactive tissue. disturbance of circulation (shock, vessel damage, edema, bandaging ) 4 lack of local braking 5 systemic factors： 1) dystrophy营养不良：protein，vitamin, trace element 2) the use of corticosteroids，chemotherapy, radiation, etc. 3) immunocompromise：DM，tumor，cirrhosis，AIDS, etc. Types of wound healing primary healing：（一期愈合） based on original cells, with a well functional rehabilitation Secondary healing：（二期愈合） based on fibrous tissue, recovering with functional disturbances: malformation, stenosis, dysfunction, etc. Diagnosis Diagnosis I. History： (1)causes：injurious objects，means，direction, etc. (2)symptoms and evolution after injury (3)Past History: eg. DM。 II. Physical examination： (1)general conditions：con