第3章节 损伤的修复3新.pptVIP

损伤的修复 Tissue Repair;损伤(injury)?缺损(defect)?修复(repair);修复(repair);修复形式(Types of repair);第一节 再生性修复（Regeneration）;定义:由损伤部周围的同种细胞来修复，称为再生(regeneration) Repair by cells of same type 特点:完全恢复原组织的结构及功能 ; 一 组织的再生能力 (Regenerative potentials of tissues);细胞再生能力分类(Types);1. Labile cells: continuously dividing cells; 二 组织的再生过程(Regeneration of various tissues);Regeneration of various tissues;Regeneration of various tissues;Regeneration of various tissues;Regeneration of various tissues;6.神经组织(nervous tissue);创伤性神经瘤;三 细胞再生与分化的分子机制;细胞再生与分化的分子机制;Growth factors cytokines;细胞再生与分化的分子机制;第二节 纤维性修复 (Fibrous repair);纤维性修复,瘢痕修复(Scar repair) 再生能力弱或缺乏再生能力的组织； 无原组织的结构及功能 不完全修复(incomplete repair);肉芽组织（granulation tissue);一 肉芽组织(granulation tissue); Granulation tissue: morphology; Granulation tissue: function;二 瘢痕组织（scar tissue）;瘢痕组织形态(morphology);瘢痕组织的作用(function);Complications of Scar ---Excessive scar formation ;②瘢痕粘连(Adhesions): 肠粘连 ;④肥大性瘢痕(Hypertrophic Scar): ;第四节 创 伤 愈 合(Wound healing);创伤愈合(wound healing) 是指机体遭受外力作用，皮肤等组织出现离断或缺损后的愈复过程。; 一 创伤愈合的基本过程(Basic courses of wound healing); 1. 一期愈合(Healing by first intention) There is a clean wound with well-apposed edges, and minimal clot formation.;1．一期愈合（Healing by first intention） 条件: 组织缺损少,创缘整齐,对合好,无感染， 特点: 血凝块少,炎症反应轻,表皮再生1-2d,肉芽组织3d,胶原纤维形成5-6d,完全愈合2-3w 结局: 线状瘢痕;2.二期愈合 (Healing by second intention) Wound edges cannot be apposed, or following wound infection, or large tissue defect. More granulation tissue.;2.二期愈合（Healing by second intention） 条件 组织缺损较大,创缘不整,对合不佳,伴有感染 特点 ①坏死组织多,炎症反应明显； ②伤口大,收缩明显,多量肉芽组织; ③愈合时间较长,形成的瘢痕较大;三 影响创伤愈合的因素 Factors affecting wound healing; 影响创伤愈合的因素(续);Poor wound healing in a patient being treated with corticosteroids.;四 骨折愈合(Fracture healing);1.血肿形成期 (Hematoma formation)1-2dHematoma Inflammation – PDGF, IL, TGF;;3.骨性骨痂形成期(Bony callus formation);软骨性骨痂 (cartilage callus);骨性骨痂 (bony callus);Osteoblasts ;4. 骨痂改建期Bony callus remodelling ;骨性骨痂改建(Bony callus remodelling );Summary: