摘要
目的探讨动力辅助血管转流术在兔离断肢体再植中的作用。方法健康清洁级家兔80只,雌雄不限,体重1.8-2.5 kg。建立兔后肢腹股沟水平环形离断、仅股动静脉相连的离断肢体模型。其中60只实验动物夹闭股动脉后,随机分成3组（n=20）,分别采用动力辅助高流量血管转流（A组）、动力辅助低流量血管转流（B组）、无动力辅助血管转流（C组）的方法重建股动脉血供,其余20只不夹闭股动脉作为假手术对照（D组）。于转流前及转流术后1、3、6、12 h撤除转流管,取股静脉远端回流静脉血,检测丙二醛（malondialdehyde,MDA）、乳酸脱氢酶（lactate dehydrogenase,LDH）和肌酸激酶（creatine kinase,CK）含量,以及腓肠肌组织髓过氧化物酶（myeloperoxidase,MPO）、MDA含量及湿干重比值,并观察血栓形成及肢体成活情况。结果转流术前各组血清MDA、LDH、CK以及腓肠肌MPO、MDA和湿干重比值比较,差异均无统计学意义（P〉0.05）;转流术后各时间点A、D组间差异均无统计学意义（P〉0.05）;与A、D组比较,B、C组各指标均明显升高,其中C组升高最明显,且以转流后12 h最高,差异均有统计学意义（P〈0.05）。A组肢体均成活且血栓形成率最低,而C组肢体成活最少且血栓形成率最高。结论动力辅助血管转流术能保证兔离断肢体血供,降低肢体缺血再灌注损伤,提高再植后肢体成活率。
Objective To investigate the effect of power-assisted intravascular shunt in replantation of amputated limbs of rabbits.Methods Eighty rabbits weighing 1.8-2.5 kg（male or female） were selected to establish the model of circular amputation at the hind groin,only femoral arteries and veins were completely preserved.After the femoral artery was clamped in 60 rabbits,the rabbits underwent power-assisted intravascular shunt with high-flow rate（group A,n=20）,powerassisted intravascular shunt with low-flow rate（group B,n=20）,and no power-assisted intravascular shunt（group C,n=20）to reconstruct blood supply;the femoral artery was not clamped in another 20 rabbits of sham group（group D）.Before and after intravascular shunt（1,3,6,and 12 hours）,the malondialdehyde（MDA）,lactate dehydrogenase（LDH）,and creatine kinase（CK） of the serum were determined.The myeloperoxidase（MPO）,MDA,and wet to dry weight ratio（W/D ratio） of the gastrocnemius muscle were measured,and the thrombogenesis and survival rate of limb were observed.Results Before intravascular shunt,MDA,LDH,and CK of the serum and MPO,MDA,and W/D ratio of the muscle showed no significant difference among 4 groups（P〉0.05）.At each time point after intravascular shunt,no significant difference was found in all indexes between groups A and D（P〈0.05）;the indexes of groups B and C were significantly higher than those of groups A and D（P〈0.05）;the values were the highest in group C（P〈0.05）,and reached the peak at 12 hours.All limbs of group A survived with low thrombosis rate,and less limbs could survive with high thrombosis rate in group C.Conclusion The power-assisted intravascular shunt with high-flow rate can effective ensure the blood supply of the amputated limbs of rabbits with lower limb injury and higher survival rate of amputated limbs after replantation.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2014年第12期1519-1524,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
广东省医学科研基金课题资助项目(A2013857
B2014119)~~
关键词
动力辅助
血管转流术
缺血再灌注损伤
肢体离断
兔
Power-assisted
Intravascular shunt
Ischemia reperfusion injury
Amputated limb
Rabbit
