外用罂粟碱霜对扩张皮肤血流量及扩张皮瓣成活长度的影响  

Experimental study on enhancement of blood flow and surviving length of expanded skin with papaverine cream

作　　者：栾杰[1] 唐勇[1] 张旭辉[1] 王黔[1] 杨佩瑛[1] 侯典举[1] 马桂娥[1] 

机构地区：[1]中国医学科学院中国协和医科大学整形外科医院,北京100041

出　　处：《实用美容整形外科杂志》2002年第4期209-212,共4页Journal of Practical Aesthetic and Plastic Surgery

基　　金：卫生部科学基金资助项目 ( 96 - 1- 0 4 7)

摘　　要：目的　探讨外用罂粟碱霜对扩张皮肤的血流量及对扩张皮瓣成活长度的影响。方法　以小型猪为实验动物 ,将罂粟碱霜用于组织扩张过程 ,分别与罂粟碱全身给药和囊内导入 2种方式以及常规扩张进行对照 ,观察在扩张前后及给药前后扩张皮肤的组织血流量以及扩张皮瓣成活长度的差异。结果　扩张注水前外用组皮肤血流量值较其它组明显较高 (P <0 .0 5)。在扩张后外用组较其它各组仍处于较高水平 (P <0 .0 1 ) ;给药前外用组皮肤血流量值较其它 2组高 (P <0 .0 5) ;外用组在给药后 ,扩张皮肤的血流量值不断上升并最终高于其它各组 ,至 2 4 0分钟时与其它各组明显差异 (P <0 .0 5) ;术后 1 0天外用组平均皮瓣成活长度为 (1 3 .67± 1 .2 8)cm ,导入组为 (1 1 .0 7± 0 .88)cm ;肌注组为 (1 0 .79± 0 .49)cm ,对照组为 (9.49± 0 .77)cm ,外用组与其它各组之间差别均非常显著 (P <0 .0 1 ) ;外用组扩张包膜组织中罂粟碱的平均含量为 (3 .5± 1 .2 ) μg/g,导入组和肌注组包膜组织中及各组动物血液中均检测不到罂粟碱含量。结论　外用罂粟碱霜剂能够透过皮肤并有效地发挥扩张血管的作用 ,从而增加扩张皮肤的血流量 ,增加扩张皮瓣的成活长度。对于扩大组织扩张术的应用范围、减少并发症。Objective To evaluate the effect of papaverine cream on increasing blood flow of expanded skin and surviving length of expanded flaps. Methods Eight mini pigs were divided into 4 groups. During expander inflation, papaverine was applied externally in group A, delivered through a delivery system in group B, injected into muscle in group C, and not given in group D. The blood flow of expanded skin was examined before and after inflation and drug delivery. The lengths of survived flaps were measured. The concentration of papaverine in fibrous capsule was detected. Results The blood flow of expanded skin remained a statistically different higher level in group A before and after expansion. After papaverine delivery, the blood flow rose up smoothly and remain a high level in group A. In other groups, it rose up and fallen down quickly in 240 minutes. The average surviving length of expanded flaps in group A was (13.67±1.28)cm, (11.07±0.88)cm in group B, (10.79±0.49)cm in group C, and (9.49±0.77)cm in group D. There was very significant difference between each group. The concentration of papaverine in fibrous capsule of group A was (3.5±1.2)μg/g. Papaverine was detected neither in the skin of other groups nor in the blood of all groups. Conclusion Papaverine cream can permeate through skin and maintain high concentration and continuous effect in local tissue. External use of papaverine cream can improve the microcirculation of expanded skin with a result of prolongation of surviving length of expanded flaps. The results indicate the value of the technique to enlarge candidates, reduce complications, and improve the effect of tissue expansion.

关 键 词：组织扩张术 罂粟碱 微循环 

分 类 号：R622.9[医药卫生—整形外科]