药物对家兔睾丸扭转复位后睾丸成活率的影响  

The combined application of low molecular dextran, papaverine and low molecular weight heparin sodium to improve testicle survival rate after the reduction of testicular torsion in rabbits

作　　者：王富军[1] 董俊强[1] 王浦[1] 苑登强[1] 耿怀振[1] 

机构地区：[1]山东省菏泽市立医院泌尿外科,274000

出　　处：《中华泌尿外科杂志》2016年第3期223-226,共4页Chinese Journal of Urology

摘　　要：目的 观察药物对家兔睾丸扭转复位固定术后睾丸血流的影响.方法 2014年10月至2015年6月,选取雄性家兔36只,月龄10 ～ 14个月.体重1.8～2.4 kg.采用随机数字表法分为实验组与对照组,每组18只.建立睾丸扭转模型：纵行切开左侧阴囊,游离左侧睾丸,将睾丸逆时针扭转720°,9h后手术复位,睾丸颜色均较暗,温盐水热敷后睾丸颜色均无明显好转,切开睾丸白膜后均无新鲜血液流出,均保留睾丸并固定.实验组联合应用低分子右旋糖酐（5 ml/kg,耳缘静脉注射,1次/d）、罂粟碱（1.5 mg/kg,肌肉注射,3次/d）、低分子肝素钠（200 IU/kg,皮下注射,1次/d）,共5d;应用青霉素（4万U/kg,肌肉注射,1次/d）,共7d.对照组仅应用青霉素预防切口感染,用法、用量同实验组.在睾丸扭转复位术后第7天,应用彩色多普勒超声检查睾丸血运,根据血流信号分为0、1、2、3级,2、3级定义为睾丸成活;手术切开阴囊,观察睾丸颜色红润、质韧,切开白膜后有新鲜血液流出定义为睾丸成活.结果 实验组睾丸血运0级4例,1级3例,2级4例,3级7例;对照组0级9例,1级2例,2级4例,3级3例.手术探查观察实验组11例睾丸成活,对照组7例成活,差异有统计学意义（P＜0.05）.结论 联合应用低分子右旋糖酐、罂粟碱、低分子肝素钠可促进睾丸扭转复位后的血运恢复,提高睾丸的成活率.Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits.Methods From October 2014 to June 2015,36 male rabbits （weighing 1.8-2.4 kg,10-14 months of age） were randomly divided into experimental group and control group,18 in each group.Produced by surgical testicular torsion model （720° counterclockwise rotation of the left side testicle）,every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water,all the testicles were observed no significant improvement in colors,and no fresh blood flow after opening tunica albuginea,then all the testicles were retained and fixed.Low molecular dextran（5 ml/kg,ear marginal vein injection,1/d）,papaverine（1.5 mg/kg,intramuscular,3/d） and low molecular weight heparin sodium （200 IU/kg,subcutaneous,l/d） were applied to promote testicular revascularization for 5 days in experimental group,and penicillin （40 000 U/kg,intramuscular,1/d） for 7 days.Control group was only given penicillin （40 000 U/kg,intramuscular,1/d） to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0,1,2,3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened,according to color,texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened,to determine whether the testicle was alive.The testicle was ruddy,flexible,and fresh blood was observed,which could prove testicular survival.Results In experimental group,the testicular blood flow siganals：0 class 4 cases,1 class 3 cases,2 class 4 cases,3 class 7 cases.In control group,the testicular blood flow siganals：0 class 9 cases,1 class 2 cases,2 class 4 cases,3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group,which was significantly difference （P 〈 0.05）.Conclusi

关 键 词：睾丸扭转 低分子右旋糖酐 罂粟碱 低分子肝素钠 睾丸成活 

分 类 号：R697[医药卫生—泌尿科学]