三种灌注液对断指再植组织再灌注损伤保护作用的研究  

The effect of perfusion solutions on ischemia reperfusion injury in replantation

作　　者：林平[1] 曹扬[1] 陈中[1] 劳杰[2] 姜丹生[1] 邢进峰[1] 汪志明[1] 倪东亮[1] 施铁军[1] 

机构地区：[1]金华市中心医院骨科,浙江321000 [2]复旦大学附属华山医院手外科

出　　处：《中华手外科杂志》2006年第4期252-254,共3页Chinese Journal of Hand Surgery

基　　金：金华市科研计划资助项目(2003-1-322)

摘　　要：目的研究三种不同灌注液对断肢再植后缺血再灌注损伤的保护作用。方法建立大鼠后肢的断肢再植模型,应用3种不同灌注液(A组肝素钠组,B组肝素钠+利多卡因组,C组肝素钠+地塞米松组)对离断肢体进行灌注,然后进行再植。分别于缺血前、缺血6h、通血60 min取材,测定断肢皮肤中丙二醛(MDA)、透射电镜观察缺血6h后再通血60 min血管内膜的改变。结果3组再植肢体成活率相当,B组灌注前后MDA差值明显低于A组,差异有统计学意义。B组、C组血管内膜改变较A组轻微。结论断肢再植前应用含利多卡因、地塞米松灌注液对离断指进行灌注,可以减轻再植肢体的缺血再灌注损伤,且对血管内膜有保护作用。Objective To investigate the protective effect of three different kinds of perfusion solutions used in replantation on the ischemia reperfusion injury, Methods Replantation model of rat hindlimb was sct up and replantation was done after perfusing the amputated limb with three different kinds of perfusion solutions, Heparin sodium, heparin sodium plus lidocaine, and heparin sodium plus dexamethasone were used in group A, group B and group C respectively. Samples were taken from the limb right before iscbemia, 6 hours after iscbemia, 60 minutes after reperfusion for measurement of MDA in the skin of the amputated limb, The changes of arterial intima were observed under scanning electron microscope for samples of 6 hours after ischemia and 60 minutes after reperfusion. Results The survival rate of replanted limbs among three groups was almost the same, The MDA level in group B before and after perfusion was obviously lower than that in group A, with statistically significant difference, The change of blood vessel intima in group B and group C was mimer than that in group A, Conclusion Perfusing the amputated limbs with a solution that contains lidocaine and dexamethasone before replantation can not only reduce the ischemiareperfusion injury of amputated limb but also protect blood vessel intima.

关 键 词：再植 再灌注损伤 灌注 

分 类 号：R658.1[医药卫生—外科学]