摘要
目的 观察外用不同浓度前列腺素E1(PGE1)治疗皮瓣血液循环障碍的疗效。 方法于 30只兔背部两侧各制作 1条超长比例皮瓣 (长 6 .0cm、宽 2 .5cm)。配制质量浓度 0 .2 %、0 .4 %、0 .8%的PGE1乳膏涂抹于皮瓣表面 ,依次分为A、B、C 3个用药组 ,每组 10条皮瓣。以实验兔自身对侧皮瓣涂抹无PGE1的基础乳膏为对照组 ,共 30条。于用药前、用药后 5、10、15、2 0、30、4 5、6 0min观测皮瓣的血液灌流情况。用药后 2h取皮瓣组织标本 ,染色后行病理学观察并镜下测量皮瓣内微血管管腔横截面积。于术后 3d测定皮瓣的成活面积 ,计算其相对成活长度。在此基础上 ,对 7例临床上可能出现坏死的皮瓣外用 0 .4 %PGE1乳膏 ,观察皮瓣的转归。 结果 动物实验中可见A、B、C组用药后皮瓣的血流灌注单位明显升高 ,普遍于用药后 30～ 6 0min达到高峰 ,分别为 (8.4± 0 .5 )、(9.1± 0 .9)、(15 .6± 1.9)Pu。与对照组 (6 .1± 0 .7)～ (6 .2± 0 .8)Pu比较 ,差异有显著性意义 (P <0.0 5);显微镜下见A、B、C组皮瓣内微血管明显扩张 ;术后A、B组实验兔的皮瓣成活面积和相对成活长度较其他组明显升高 (P <0.0 1)。7例患者用药后皮瓣远端全部成活。 结论 外用 0 .2 %、0 .4 %的PGE1软膏可明显改善皮瓣的血液灌流 ,促进皮瓣成?
Objective To evaluate the efficiency of PGE 1 in relieving the circulatory disorder of ischemic skin flap. Methods New Zealand rabbits were employed in the study with skip flaps each with the size of 2.5x6.0cm 2 being raised from the back. PGE 1 cream in different concentrations, i.e. 0.2%, 0.4%, 0.8% was respectively topically applied to the skin flaps forming 3 groups (n=10 in each group), while pure cream without PGE 1 was applied to those in control group (n=30). The PGE 1 was applied 1 hour after the flap was opened, raised and sutured back. Blood perfusion in the flap was measured with Laser Doppler flowmetry before and 5, 10, 15, 20, 30, 45 and 60 mins after PGE 1 application. The tissue samples from the skin flap were harvested at 2 hours after PGE 1 application for immunohistological staining, and the cross sectional area of capillary lumens was measured under microscope. The survival area of the flap was assessed on the 3 rd day after operation for the calculation of relative survival length of the flap. Clinically, PGE 1 ointment was applied onto the skin flap vulnerable to necrosis, and the outcome of the flap was observed thereafter. Results The blood perfusion in animal skin flaps was increased evidently after PGE 1 application, especially at 30 mins after PGE 1 usage when compared with that in control group (P < 0.05). The capillaries in the skin flap in PGE 1 application groups were dilated obviously after drug usage as observed under microscope (P < 0.05). The survival area and relative survival length in groups 1 and 2 on the 3 rd post-operational day were much more increased when compared with those in other groups (P< 0.01). Clinically, the skin flaps treated with PGE 1 survived well even in the distal end of the flaps. Conclusion The blood perfusion and the survival rate of the skin flaps could be improved by local application of PGE 1 in concentrations of 0.2% or 0.4%.
出处
《中华烧伤杂志》
CAS
CSCD
2004年第2期88-91,共4页
Chinese Journal of Burns
