参附对肢体缺血再灌注损伤保护作用的时效及量效关系探讨  

Time-effect and dose-effect relationship about protection functions of Shenfu injections for reinfusion injury of ischemic limbs

作　　者：黄卫[1] 王剑利[2] 张应鹏[1] 钟波[1] 王素伟[1] 

机构地区：[1]珠海市人民医院脊柱骨病科,广东珠海519000 [2]中国人民解放军第89医院创伤骨科,山东潍坊261021

出　　处：《实用手外科杂志》2009年第2期82-83,122,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨参附注射液对肢体缺血再灌注损伤保护作用的机制、时效及量效关系。方法选择合适病例如断肢再植、皮瓣移植、四肢大血管损伤、骨筋膜室综合征等或四肢手术需用止血带1～1．5h的男性患者45例，随机分为A，B，C，D和E（空白对照组）五组，A，B组在手术前30min、术后30min分别以参附注射液10ml／kg加入5％糖盐水（GNS）静脉滴注，C，D组在手术前30min、术后30min分别以参附注射液20ml／kg加入5％GNS静脉滴注，E组单纯静脉滴入5％GNS，每组分别在术前1h、术后6h抽取静脉血，测定丙二醛（MDA）、血浆超氧化物歧化酶（SOD）含量。结果各治疗组中SOD明显增高，MDA明显降低。结论参附注射液对缺血再灌注肢体具有保护作用，且术前治疗效果更佳。Objective To study the mechanism, time-effect and dose-effect relationship about the protection functions of the shengfu injection for the reinfusion injury of ischemic limbs.Methods 45 patients were randomly divided into 5 groups as A,B,C,D,E （Blank control group）,who had limb replantation, flap transplantation, limb vascular injuries, bone compartment syndromes or limb surgeries with tourniquet for 1.0-1.5hour.Group A and Group B were dripped intravenously with the Shenfu injection with 10ml/kg and 5% glucose in normal saline 30 minutes before and after operation respectively.Group C and Group D were dripped intravenously with the Shenfu injections with 20ml/kg and 5% glucose in normal saline 30 minutes before and after the operation respectively. Group E was dripped intravenously with 5% glucose in normal saline only. Veins blood samples of five groups were collected 1 hour before operation and 6 hour after operation. Contents of MDA and SOD in blood samples were determined.Results SOD increased markedablely; MDA decreased markedablely in the therapied groups.Conclusion The Shengfu injection can surely alleviate the reinfusion injury of the ischemic limbs, with better effects admitted pre-operations.

关 键 词：参附注射液 肢体缺血再灌注损伤 血浆超氧化物歧化酶(SOD) 丙二醛(MDA) 

分 类 号：R654.3[医药卫生—外科学] R259.416.1[医药卫生—临床医学]