血管内止血带研制的实验研究  

The invention of internal tourniquet and its experimental studies

作　　者：贺道华 张新元[2] 杨铭[2] 潘力[2] 刁波[2] 马廉亭[2] 

机构地区：[1]广州市番禺区中心医院神经外科,511400 [2]广州军区武汉总医院神经外科

出　　处：《中华实验外科杂志》2014年第11期2456-2458,共3页Chinese Journal of Experimental Surgery

基　　金：广州军区总后勤部卫生部2010年度临床高新技术重大项目（2010gxjs034）

摘　　要：目的 研制一种自制的血管内止血带,并进行动物实验,探讨血管内止血带止血的效果及其安全性.方法 随机将40只大白兔分为4组：A组16只,持续阻断右侧颈总动脉1h;再分为A1、A2、A3、A4亚组,每组4只,分别于血管内止血带置入后1h、5、14、21 d取右颈总动脉与球囊接触动脉标本,分别送作血管组织匀浆,酶联免疫吸附试验（ELISA）法检查半胱氨酰天冬氨酸特异性蛋白酶（Caspase）-3浓度、原位缺口末端标记法（TUNEL）法检测细胞凋亡数.B组16只,持续阻断右侧颈总动脉2h,检查项目同A组.C组,空白对照组4只,不插入血管内止血带,检查项目同A组.D组,假手术组4只,切开皮下各层暴露右颈总动脉后1h,检查项目同A组.结果 C、D、A1、A2、A3、A4、B1、B2、B3、B4组Caspase-3浓度（μmoL/L）分别为：10.35±0.82、12.22±2.41、11.35±1.63、18.93±1.01、24.30±1.64、15.63±2.43、12.09±0.83、19.36±2.45、26.29±3.30、14.35±3.28;C、D、A1、A2、A3、A4、B1、B2、B3、B4组TUNEL染色阳性数分别为：0.26±0.20、0.29±0.02、0.38±0.03、0.44±0.06、0.59±0.05、0.42±0.07、0.40±0.04、0.54±0.05、0.63±0.08、0.48±0.05.血管内止血带置入术后Caspase-3浓度、凋亡阳性细胞数于术后5d增加,术后14 d达高峰,术后21 d仍处于较高水平;血管内止血带置入术后B组分别与同时段A组比较,B组Caspase-3浓度和凋亡阳性细胞数高于A组（P＜0.05）.结论 血管内止血带持续阻断血流不超过2h时安全有效.Objective To study the effect and safety of a self-made internal tourniquet by experimental studies.Methods 40 rabbits were randomly divided into four groups：group A,16,intravascular tourniquet continuing to block up the right common carotid artery for 1 h; further divided into A1,A2,A3,A4-group （n =4） respectively,1 h,5,14,21 days after the placement of intravascular tourniquet; the right common carotid artery is divided into two sections to be sent for immunohistochemistry [by TdT-mediated dUTP nick end labeling （TUNEL）] and enzyme linked immunosorbent assay （ELISA） examination cysteinyl aspartate-specific protease-3 （Caspase-3） ; In group B,16,intravascular tourniquet continued to block up the right common carotid artery for 2 h; further divided into B1,B2,B3,B4 group （n =4） respectively,the examination is the same as group A.Group C,the blank control group,4,intravascular tourniquet is not placed in the right carotid artery,the examination is the same as group A.Group D,sham operation group 4,expose the right common carotid artery for 1 h,the examination is the same as group A.Results The Caspase-3 concentrations （μmol/L） in group C,D,A1,A2,A3,A4,B1,B2,B3,B4 were 10.35 ±0.82,12.22±2.41,11.35 ±1.63,18.93 ±1.01,24.30±1.64,15.63 ±2.43,12.09± 0.83,19.36 ± 2.45,26.29 ± 3.30,14.35 ± 3.28 respectively ; The apoptotic cells in group C,D,A1,A2,A3,A4,B1,B2,B3,B4 were 0.26 ±0.20,0.29 ±0.02,0.38 ±0.03,0.44 ±0.06,0.59 ± 0.05,0.42 ± 0.07,0.40 ± 0.04,0.54 ± 0.05,0.63 ± 0.08,0.48 ± 0.05 respectively.The Caspase-3 concentrations and apoptotic cells increased after 5 d,reached the peak after 14 d,remained at a high level after 21 d; Caspase-3 levels and apoptotic cells in B group had significant difference compared with those in B group.Conclusion Internal tourniquet is a safe and effective to occlude the blood flow in common carotid artery.

关 键 词：血管内止血带 动脉损伤 手术 

分 类 号：R472[医药卫生—护理学]