随机对照研究大鼠皮下不同分离方式致炎症介质水平的变化  

Randomized controlled study of serum level of inflammatory mediator resulting from different skin incision and separation between different subcutaneous layers of rats

作　　者：吴庆华[1] 仇明[1] 江道振[1] 张伟[1] 郑向民[1] 

机构地区：[1]第二军医大学附属长征医院普外科,上海201103

出　　处：《国际外科学杂志》2013年第3期167-170,F0003,共5页International Journal of Surgery

摘　　要：目的通过对比大鼠不同皮肤切口及皮下不同分离层次致血清炎症介质水平的变化情况，验证特定皮下组织层次内的分离具有相对的微创性。方法将32只雄性SD大鼠随机（以PASWStatistics18．0软件随机数生成器产生随机表）分为4组，每组8只。实验组1：常规切口＋浅筋膜下分离；实验组2：常规切口＋真皮下分离；实验组3：常规切口＋浅筋膜下扩大分离；实验组4：扩大切口（剑突平面的3cm横切口）＋浅筋膜下分离。分别于术前、术后2h、12h、24h及48h采血，对比各组不同时相血清IL·6和中性粒细胞弹性蛋白酶增量水平。结果血清IL-6和中性粒细胞弹性蛋白酶增量水平各组间比较，实验组1和实验组3差异无统计学意义（P=0．074，P=0．096）；实验组2和实验组4差异也无统计学意义（P=0．747，P=0．897）；实验组1、3与2、4的IL-6及中性粒细胞弹性蛋白酶增量值交叉比较差异均有统计学意义（P〈0．01）。结论结合皮肤小切口的大鼠浅筋膜下的分离操作具有相对的微创性。Objective To investigate and confirm the value of minimal invasion of separation between specific subcutaneous layers of rats. Methods Thirty- two male SD rats were randomized into four groups, group 1 ： normal incision plus separation beneath superficial fascia; group 2： normal incision plus subdermaL separation; group 3： normal incision plus extended separation beneath superficial fascia; group 4： extended incision plus separation beneath superficial fascia. Blood sampling was taken preopeatively, 2 h, 12 h, 24 h and 48 h postoperatively. The increase of serum IL-6 and neutrophil elastase levels were compared between different groups. Results Compared with each other, the increase of serum IL-6 and NE levels in group 1 vs 3 and group 2 vs 4 was not different signifi- cantly （ P value was 0. 074, 0. 096 and 0. 747, 0. 897, respectively）. However, the increase of serum levels in group 1 vs 2, 1 vs 4, 3 vs 2 and 3 vs 4 was different significantly （ P 〈 0.01 ）. Conclusion Operation of separating beneath superficial fascia plus small skin incision in rats conduces to relatively minimal invasion.

关 键 词：皮下组织 膜样层 炎症 外科手术 微创性 

分 类 号：R363[医药卫生—病理学]