摘要
目的探讨新型血管损伤快速转流装置在犬肢体损伤中应用的安全性及有效性。方法取成年比格犬18只,雌雄不限,体质量(20±2)kg,于一侧后肢膝关节上方环形离断,制作仅保留皮肤、股动脉、股静脉、股神经及股骨的半离断模型后,将股动脉夹闭2 h,造成远端肢体缺血环境;然后,动物模型随机分成3组(n=6),切除约3 cm股动脉,分别采用新型血管转流装置转流并经补液口补充生理盐水(A组)、静脉注入肝素钠注射液后置入新型血管转流装置转流并经补液口补充3%肝素钠溶液(B组)、输液管临时剪裁自制转流管转流(C组),12 h后结束转流。测量转流前后犬生命体征(体温、心率、血压),记录转流管置入所需时间以及转流过程中通畅情况、有无脱落及血栓形成等;测量转流前及转流后3、6、9、12 h血常规及凝血指标[白细胞计数(white blood cell,WBC)、红细胞计数(red blood cell,RBC)、血小板计数(platelet,PLT)、血红蛋白(hemoglobin,HGB)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、血浆纤维蛋白原(fibrinogen,Fib)]以及生化指标[乳酸脱氢酶(lactic dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)];取转流前后术侧腓肠肌,大体观察肌肉坏死情况、测量湿干重比值以及丙二醛(malondialdehyde,MDA)及髓过氧化物酶(myeloperoxidase,MPO)含量,另取转流后腓肠肌和股动脉标本行HE染色观察。结果转流前后3组间体温、心率、血压比较,差异均无统计学意义(P>0.05)。与A、B组比较,C组转流管置入所需时间较长(P<0.05),转流管内血栓数量、发生堵塞时间均增加(P<0.05);A、B组转流管置入后均无脱落,C组3例发生转流管脱落或滑动,但组间转流管脱落发生率比较差异无统计学意义(P=1.000)。转流前3组血常规及凝血指标、LDH、CK、腓肠肌湿干重比值以及MPO、MDA含量比较,差异均无统计学意义(P>0.05)。转流后,3组血常规及凝血指�
Objective To explore the effectiveness and safety of a new temporary intravascular shunt(TIVS) device for limb injury in dogs. Methods Eighteen adult beagle dogs, male or female, weighing(20±2) kg, were taken for experiment. A semi-amputated limb model was made by circular amputating the knee joint of one hindlimb, which retained only skin, femoral artery, femoral vein, femoral nerve, and femur. Then the femoral artery was clamped for 2 hours in all animals, resulting in the ischemic environment of the distal limbs. The animals were randomly divided into 3 groups(n=6). In group A, the bypass was started by using a new TIVS device and replenishing saline through the infusion port;In group B, after intravenous injection of heparin sodium solution, the bypass was started by using a new TIVS device and replenishing 3% heparin sodium solution through the infusion port;In group C, the bypass was started by using the self-made bypass tube. The bypass was end after 12 hours. The general vital signs(body temperature, heart rate, blood pressure) before and after bypass were measured, and the time required for the insertion of the bypass tube, the patency during the bypass, shedding, and thrombosis were recorded. Routine blood test and blood coagulation indicators[white blood cell(WBC), red blood cell(RBC), platelet(PLT), hemoglobin(HGB), activated partial thromboplastin time(APTT), fibrinogen(Fib)] and biochemical indicators [lactic dehydrogenase(LDH) and creatine kinase(CK)] were recorded before bypass and after 3, 6, 9, and 12 hours of bypass, respectively. The gastrocnemius muscles on the surgical side before and after bypass were harvested and the muscle necrosis, the wet-to-dry weight ratio, and the content of malondialdehyde(MDA) and myeloperoxidase(MPO) were measured. In addition, the gastrocnemius muscle and femoral artery were observed after bypass by HE staining. Results There was no significant difference in body temperature, heart rate, and blood pressure between groups before and after bypass(P>0.05). Compare
作者
单长蒙
徐永清
SHAN Changmeng;XU Yongqing(Kunming Medical University,Kunming Yunan,650000,P.R.China;Department of Orthopedics,the 920th Hospital of Joint Logistics Support Force,Kunming Yunnan,650000,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2021年第6期734-741,共8页
Chinese Journal of Reparative and Reconstructive Surgery
基金
军队后勤科研重大项目(2019-ky-0254)
云南省创伤骨科临床医学中心项目(ZX20191001)。
