摘要
目的 探讨重组组织因子途径抑制物（rTFPI）在治疗大鼠碾压撕脱皮瓣中的应用效果。方法2013年5月至2015年6月，30只sD大鼠被随机数字分为3组：对照组、碾压撕脱组和rTFPI治疗组，每组10只。在所有sD大鼠背部设计一个8．0cm×2．5cm的随机皮瓣．碾压撕脱组和治疗组的皮瓣被一个特殊装置造成碾压撕脱伤，原位缝合后各组连续治疗3d。对照组、碾压撕脱组注射磷酸缓冲液，治疗组注射rTFPI。在术后第3天观察皮瓣的微循环变化，第7天测量皮瓣的成活面积。应用SPSS19．0进行统计分析。结果与对照组、碾乐撕脱组和rTFPI治疗组皮瓣的成活率分别为（62．5±6．5）％、（32．7±5．2）％和（51．6±8．2）％，各组之间比较，差异均有统计学意义（P〈0．05）。激光多普勒和红外线热成像系统检查显示，在rTFPI组血流灌注能够达到皮瓣的中段，而碾压撕脱组仅能达到近段。结论rTFPI可以有效增加碾压撕脱皮瓣的成活面积，临床上可能对预防碾压撕脱皮瓣坏死有作用。
Objective To determine whether rTFPI could inhibit vascular thrombosis and salvage random pattern skin flaps following AIRC in rat models. Methods From April, 2013 to June, 2015, 30 adult male Sprague-Dawley rats were randomized into 3 groups; a control group, an avulsion injury with roll compaction （AIRC） group, and an AIRC plus rTFPI therapy group. An 8.0 cm× 2.5 cm random flap was raised on the dorsum of each rat. The AIRC and AIRC plus rTFPI flaps were then altered with a device designed to simulate avulsion in- jury with roll compaction. After flap closure primarily, treatment was initiated immediately and continued for 3 days. Phosphate buffered saline was used in the control group and the AIRC group, while the AIRC plus rTFPI group re- ceived the recombinant Tissue Factor Pathway Inhibitor. Laser Doppler flowmetry anti infi＇a-red thermalgraphy were used on postoperative day three to assess microcirculatory blood flow and viability of the avulsed flaps. At postoper- ative day seven, final flap sruvival was determined. Using SPSSI9.0 statistical analysis. Results The flap survival in AIRC group was only （32.7 ± 5.2）% versus （62.5 ± 6.5）% in control group, but the flap survival significantly increased （51.6± 8.2）% after topical injecting rTFPI in experimental group. Statistically significant differences exist （P 〈 0.05） between every two groups. The detection results of Laser-Doppler flowmetry and infra-red thennography showed that peffusion arrived the centre of the flaps in experimental group, while peffusion only arrived the proximal part of the flaps in the AIRC control group. Conclusion rTFPI therapy is effective in reducing ischemic necrosis of random pattern flaps following avulsion injury in the rat model. It suggests that rTFPI therapy may play an important role in clinical salvage of the failing avulsion injuries with roll compaction.
出处
《中华显微外科杂志》
CSCD
北大核心
2016年第4期359-362,共4页
Chinese Journal of Microsurgery
基金
南京军区科研创新课题（11MA123）
关键词
皮瓣撕脱伤
重组组织因子途径抑制物
外源性凝血途径
大鼠
Skin flap avulsion injuries
Recombinant tissue factor pathway inhibitor
Extrinsic coagulation pathway
Rat
