土鳖虫对兔耳逆行皮瓣存活的影响及机制研究  

Effect of Trionyx sinensis on the survival of rabbit ear retrograde flap and its mechanism

作　　者：陈龙 秦东[2] 苗祎祎 张俊忠[4] Chen Long;QIN Dong;MIAO Yi-yi;ZHANG Jun-zhong(Shandong University of Traditional Chinese Medicine,Ji'nan 250355,China;Rizhao Hospital of Tradi-tional Chinese Medicine,Rizhao,Shandong,276899,China;Guizhou University of Traditional Chinese Me-dinine,Guiyang,550025,China;Affiliated Hospital of Shandong University of Traditional Chinese Medi-cine,Ji'nan 250011,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]日照市中医医院,山东日照276899 [3]贵州中医药大学,贵州贵阳550025 [4]山东中医药大学附属医院,山东济南250011

出　　处：《时珍国医国药》2022年第12期2817-2820,共4页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金(82074579);山东省自然科学基金(ZR2020MH360)。

摘　　要：目的 探讨土鳖虫对兔耳逆行皮瓣存活的影响及机制。方法 将32只健康大耳兔随机分为空白对照组、模型组、肝素钠组、土鳖虫组,每组8只兔。于兔右耳背部设计以兔耳中央动脉远端为蒂的逆行岛状皮瓣,设计皮瓣长7cm,宽3cm,蒂部宽1cm。土鳖虫组于皮瓣深层敷撒土鳖虫颗粒0.35g后将皮瓣原位缝合,肝素钠组在皮瓣深层敷撒肝素钠粉末0.29g后将皮瓣原位缝合,模型组直接将皮瓣原位缝合。空白对照组建立以兔耳中央动脉近端为蒂的顺行岛状皮瓣后将皮瓣原位缝合。术后1周大体观察各组皮瓣肿胀程度;术后第1、3、5天观察皮瓣血氧饱和度(SpO_(2));术后第2天检测血乳酸(Lac)、氧分压(PO_(2))含量水平;术后第3、5、12天各组随机取1只实验兔,病理染色后观察毛细血管内红细胞聚集程度、血栓形成情况;术后12d计算各组皮瓣存活面积。结果 (1)土鳖虫组术后皮瓣肿胀程度与模型组、肝素钠组、空白对照组比较普遍较轻。(2)术后土鳖虫组的SpO_(2)明显高于模型组、肝素钠组(P<0.01)。(3)土鳖虫组Lac含量水平低于模型组、肝素钠组(P<0.01),土鳖虫组的PO_(2)含量水平高于模型组、肝素钠组(P<0.01)。(4)土鳖虫组红细胞聚集情况及微血栓形成较模型组轻。(5)空白对照组、土鳖虫组、肝素钠组皮瓣存活明显高于模型组(P<0.01),土鳖虫组与肝素钠组比较差异无显著性意义(P>0.05)。结论 土鳖虫药物局部应用有利于促进兔耳逆行皮瓣的动脉供养及静脉回流,加快淤血肿胀的消退,改善皮瓣组织的缺氧状态,促进皮瓣血液循环的重建,有利于皮瓣的存活。Objective To investigate the effect of trionyx sinensis on the survival of retrograde flap and its mechanism.Methods Thirty-two healthy large eared rabbits were randomly divided into blank control group,model group,heparin sodium group and turtle worm group,with 8 ears in each group.A retrograde island flap pedicled with the distal end of rabbit central ear artery was designed on the back of the right ear of the rabbit.The designed flap was 7cm long,3cm wide and 1cm wide at the pedicle.The skin flap was sutured in situ in the tripod group after 0.35g of tripod particles were applied in the deep flap,the skin flap was sutured in situ in the heparin sodium group after 0.29g of heparin sodium powder was applied in the deep flap,the skin flap was sutured in situ in the model group directly,and the skin flap was sutured in situ in the blank control group after the anteriorly island flap pedicled at the proximal end of rabbit ear central artery was established.The degree of flap swelling and hematoma formation in each group were observed 1 week after operation.The blood oxygen saturation(SPO_(2)) of the flap was observed at 1,3 and 5 days postoperatively.Blood lactic acid(Lac) and oxygen partial pressure(PO_(2)) were detected on the 2 days after operation.One experimental rabbit was randomly selected from each group on day 3,5 and 12 days after surgery.Hematoxylin-eosin staining was used to observe the degree of erythrocyte aggregation and thrombosis in capillaries.The survival area of each group was calculated 12 days after operation.Results(1) Compared with the model group,the heparin sodium group and the blank control group,the swelling degree of the postoperative flap in the tripod group was generally lighter,and the dissipation rate of hematoma was significantly faster than that in the model group.(2) After operation,SpO2 in tripod group was significantly higher than that in model group and heparin sodium group(P0.05).Conclusion The local application of the medicine is beneficial to promote the arterial feeding an

关 键 词：土鳖虫 肝素钠药物 逆行皮瓣 顺行皮瓣 兔 

分 类 号：R285.5[医药卫生—中药学]