天然水蛭素对猪随意型皮瓣静脉淤血影响的实验研究  

EXPERIMENTAL STUDY ON EFFECT OF NATURAL HIRUDIN ON VEIN CONGESTION OF RANDOM SKIN FLAP IN PORCINE MODELS

作　　者：孙智勇[1] 王刚[1] 杨晓楠[1] 杨健祥[1] 滕晓颦[1] 殷国前[1] 

机构地区：[1]广西医科大学第一附属医院整形美容外科,南宁530021

出　　处：《中国修复重建外科杂志》2008年第11期1296-1300,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：广西壮族自治区科学研究与技术开发计划资助项目(桂科攻0719006-2-11)~~

摘　　要：目的探讨局部应用天然水蛭素对猪随意型皮瓣移植后静脉淤血的影响。方法6～8月龄广西巴马小型猪3只,雌雄不限,体重10～15kg。于每只猪背两侧制备6个大小为14cm×4cm的随意型皮瓣,共18个皮瓣。根据术后注射药物不同,皮瓣随机分为3组(n=6)。术后即刻、1、2、3d,A组:局部注射3mL生理盐水,作为对照组;B组:局部注射3mL天然水蛭素20ATU;C组:局部注射3mL天然水蛭素40ATU。术后1、10d行大体观察,1、7d行组织学观察,3、7d测定湿重/干重比值,5d测定皮瓣表面温度,7d皮瓣局部血流彩色超声检测,12d测定皮瓣成活率。结果术后即刻,3组皮瓣均出现远端2/3范围内轻度淤血,差异无统计学意义(P>0.05);术后1d,A组皮瓣淤血长度明显长于B、C组(P<0.05),B、C组间比较差异无统计学意义(P>0.05);术后10d,A、C组皮瓣坏死长度明显长于B组,差异有统计学意义(P<0.05),A、C组比较差异无统计学意义(P>0.05)。组织学观察:术后1d,B组真皮内毛细血管及微静脉红细胞淤滞现象较A组明显减轻;术后7d,B组皮下胶原及肉芽组织增生明显优于A组。术后3d,A、B、C组湿重/干重比值分别为3.94±0.14、3.43±0.14、3.60±0.19,A组与B、C组比较,差异有统计学意义(P<0.05),B、C组间比较,差异无统计学意义(P>0.05);术后7d,A、B、C组湿重/干重比值分别为3.61±0.11、3.08±0.13、3.34±0.21,A组与B、C组比较,差异有统计学意义(P<0.05),B、C组间比较,差异无统计学意义(P>0.05)。术后5d,A、B、C组皮瓣表面温度分别为(36.64±0.70)、(38.61±0.42)和(37.50±0.46)℃,A组与B、C组比较差异有统计学意义(P<0.05),B、C组间比较,差异无统计学意义(P>0.05)。术后7d,皮瓣局部血流彩色超声检测示A组血流信号稀少,B组见较完整的动静脉回流信号,可见垂直于皮肤的动脉穿支,C组可见动脉血流信号。术后12d,A、B、C组皮瓣成活率分别为45%±7%、67%±4%、52%±4%,B、C组与A组比较,差异有统计�Objective To investigate the effect of natural hirudin which is applied locally on vein congestion of random pattern skin flap in porcine models. Methods Three Guangxi Bama miniature pigs, including male and female aged 6-8 months and weighing 10-15 kg, were ernployed to establish animal model of vein congestive. Six dorsal random pattern skin flaps （three on each side） were prepared on each animal, 14 cm ×4 cm in size. According to the pharmacologic manipulations which were administered immediately and at 1, 2, and 3 days after operation respectively, the eighteen flaps were divided randomly into 3 groups （six in each group）. In group A, isotonic Na chloride was locally applied as control group. In group B, 3 mL of 20 ATU natural hirudin was locally applied at each flap. In group C, 3 mL of 40 ATU natural hirudin was locally applied at each flap. Macroscopic observation （at 1 and 10 days postoperatively） and histological observation （at 1 and 7 days postoperatively） were made, the ratio of wet weight to dry weight of the congestive tissue （at 3 and 7 days postoperatively）, the temperature of the surface of congestive flap （at 5 days postoperatively） and local blood flow of the flap （by Color Doppler Ultrasound at 7 days postoperatively） were measured. The survival rate of skin flaps was determined at 12 days postoperatively. Results Macroscopic observation showed that congestion of the flaps had no significance among three groups immediately after operation （P 〉 0.05）; at 1 day postoperatively, the length of the congestion of the flap in group A （9.68 ± 0.43） cm was significantly longer than that in group B （6.81 ± 0.53） cm and group C （8.51 ± 0.64） cm （P 〈 0.05）, while there was no significant difference between group B and group C （P 〉 0.05）; at 10 days postoperatively, the necrosis at the distal end of flap in group A and group C were significantly longer than that in group B （P 〈 0.05）, while there was no significant difference between group

关 键 词：天然水蛭素 随意型皮瓣 静脉淤血 小型猪 

分 类 号：R622.1[医药卫生—整形外科] R318[医药卫生—外科学]