医用耳脑胶局部注射治疗实质脏器外伤出血引起疼痛机制的动物实验研究

目的通过动物实验研究初步探讨超声引导下医用耳脑胶局部注射治疗腹部实质脏器外伤出血产生疼痛的可能机制。方法以腹腔注射医用耳脑胶及乙醇引起的小鼠扭体反应作为内脏痛的实验模型。NIH小鼠56只随机分为7组,每组8只动物,A组腹腔注射0.3mL生理盐水;B组分为B1、B2、B3亚组,分别腹腔注射医用耳脑胶0.1、0.2、0.3mL;C组分为C1、C2、C3亚组,分别腹腔注射75%乙醇0.1、0.2、0.3mL。观察各实验组30min的扭体反应,对疼痛程度进行计分。结果A、B组所有动物在30min内仅可见腹部的舔食行为,均未见明确的程度更重的扭体反应;疼痛程度计分A组为4.2±1.3,B1组为3.4±0.9,B2组为3.5±1.3,B3组为3.4±1.2;A组与B组各亚组间疼痛程度计分差异无统计学意义(P>0.05)。C组所有动物均可见不同程度的扭体反应,疼痛程度计分C1组为10.9±2.0,C2组为16.8±2.1,C3组为23.0±4.1,C组各亚组间及与A组、B组各亚组间疼痛计分差异有统计学意义(P<0.01)。结论医用耳脑胶局部注射治疗外伤出血引起疼痛主要机制可能为局部黏合的牵拉痛及局部的缺血性疼痛;医用耳脑胶可安全用于实质脏器超声引导下的微创止血治疗。

The pain mechanism of cyanoacrylate injected into abdominal organ injury sites for hemorrhage control:an animal experiment

Objective The aim of this animal experiment was to initially explore the possible pain mechanism of cyanoacrylate when directly injected into abdominal injury sites to control hemorrhage under the guidance of contrast-enhanced ultrasonography.Methods Chemical visceral pain model was established in NIH mice weighing 22～25 g(n=56) by intraperitoneal injection of cyanoacrylate and 75 % ethanol.Mice were randomly divided into seven groups,0.3 mL Sodium Chloride group(group A,n=8),0.1 mL cyanoacrylate group(group B1,n=8),0.2 mL cyanoacrylate group(group B2,n=8),0.3 mL cyanoacrylate group(group B3,n=8),0.1 mL ethanol group(group C1,n=8),0.2 mL ethanol group(group C2,n=8),0.3 mL ethanol group(group C3,n=8).All mice were then placed into an individual observation chamber to measure the writhing response.The numbers of writhes were counted in duration of 30 minutes.Results All mice of group A and B only showed abdominal lick behavior and no obviously writhing response in 30 minutes.The score of pain degree was 4.2±1.3 in group A,and 3.4±0.9,3.5±1.3,3.4±1.2 in subgroup B,respectively.The score of group A and subgroup B have no significant differences(P>0.05).The animals of group C all showed different degree of writhing response.The score of pain degree was 10.9±2.0,16.8±2.1,and 23.0±4.1 in subgroup C,respectively.The score of subgroup C and group A,subgroup B have significant differences statistically(P<0.01).Conclusion The main mechanism of pain caused by cyanoacrylate perhaps are associated with the ischemia pain and drag pain caused by local glue effect when cyanoacrylate directly injected into abdominal injury sites to control hemorrhage.Cyanoacrylate can safely used in the mini-invasive hemostasis therapy under the guidance of contrast-enhanced ultrasonography.