壳聚糖季铵盐闭式冲洗对大鼠移植皮瓣缺血再灌注损伤的影响  

Influence of closed irrigation drainage of HACC on ischemia/reperfusion injury of graft flap in rats

作　　者：郑梁[1] 余文 赵相宜 Zheng Liang;Yu Wen;Zhao Xiangyi(Department of Plastic Surgery,Taihe Hospital of Shiyan City(Taihe Hospital Affiliated to Hubei Medical College),Shiyan 442000,China;School of Basic Medicine,Hubei Medical University,Shiyan 442000,China)

机构地区：[1]十堰市太和医院(湖北医药学院附属太和医院)整形美容烧伤科,十堰442000 [2]湖北医药学院基础医学院,十堰442000

出　　处：《中华医学美学美容杂志》2020年第4期345-349,共5页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：湖北省卫生和计划生育委员会指导项目(WJ2017F076);湖北医药学院人才启动基金(2017QDJZR23)。

摘　　要：目的探讨壳聚糖季铵盐联合闭式冲洗对大鼠移植皮瓣缺血再灌注(I/R)损伤的影响。方法将45只雄性健康SD大鼠随机分为假手术组、I/R组、壳聚糖组3组,每组15只。术前测降钙素及超敏C反应蛋白,制备右下腹岛状皮瓣I/R模型。术后I/R组及假手术组用生理盐水进行冲洗。壳聚组用壳聚糖季铵盐胶体液进行冲洗。分别采集冲洗3 d、5 d、7 d的各组皮瓣组织,进行病理切片观察、移植皮瓣超氧化物歧化酶(SOD)和丙二醛(MDA)测定以及动脉血降钙素(PCT)及超敏C反应蛋白(hs-CRP)测定,并于术后7 d计算皮瓣成活比例。结果组织病理学观察显示壳聚糖季铵盐组比I/R组中性粒细胞浸润及组织水肿程度明显改善。I/R组较假手术组SOD活力逐渐降低,MDA指标逐渐升高;壳聚糖组较假手术组SOD活力降低,MDA指标升高;壳聚糖组较I/R组SOD活力逐渐升高,MDA指标逐渐降低。差异均具有统计学意义(P<0.05)。3组大鼠的动脉血降钙素及超敏C反应蛋白指标呈逐渐增高后降低趋势,壳聚糖组3 d、5 d、7 d的指标较I/R组明显下降。其中3 d、5 d指标差异具有统计学意义(P<0.05)。术后7 d I/R组皮瓣成活比例为(41.11±14.17)%,壳聚糖组皮瓣成活比例高达(85.34±10.02)%,较I/R组差异具有统计学意义(P<0.05)。结论应用壳聚糖季铵盐联合闭式冲洗可以降低炎症反应及减轻组织氧化应激反应从而提高移植皮瓣的成活率。Objective To investigate the effects of quaternary ammonium salt of chitosan combined with closed irrigation on ischemia-reperfusion injury(I/R)in rat skin flap.Methods Fourty-five adult male SD rats were randomly divided into 3 groups:sham-operated group,I/R group and chitosan group.Before operation,collection of arterial blood for testing PCT and hs-CRP were used as basic values.Right low abdominal island flap fed by the superficial epigastric artery was created in rats of all three groups.After operation,we flushed and dressed the wound with 10%saline of sham-operated group and I/R group.Quaternary ammonium salt of chitosan combined with closed irrigation were used in chitosan group.Flaps were assessed histologically at 3 d,5 d and 7 d of reperfusion.The tissue was collected to make the SOD,MDA and PCT,hs-CRP testing,pathological section observation and to calculate the flap survival rate.Results Marked neutrophil infiltration and edema were observed in I/R group,while less neutrophil infiltration was observed in chitosan group.Compared with the sham-operated group,the PCT and hs-CRP levels of the I/R group after modeling for 3 and 5 days were significantly increased.There were statistically significant differences(P<0.05);Compared with the sham-operated group,the PCT and hs-CRP levels of the Chitosan group after modeling for 3 days,5 days were significantly increased.There were statistically significant differences(P<0.05);Compared with the I/R group,the PCT and hs-CRP levels of the Chitosan group after modeling for 3 and 5 days were significantly induced.There were statistically significant differences(P<0.05);after modeling for 7 days,the values between all groups were no statistically significant differences(P>0.01).Compared with the sham-operated group,the SOD level of the I/R group after modeling for 3,5 and 7 days was significantly induced.MDA level was significantly increaesd;compared with the sham-operated group,the SOD level of the Chitosan group after modeling for 3,5 and 7 days were significantly i

关 键 词：外科皮瓣 缺血再灌注损伤 闭式冲洗 壳聚糖季铵盐 

分 类 号：R622[医药卫生—整形外科]