超短波治疗对鼠断尾再植后鼠尾内皮素的影响

目的探讨超短波（ultra—shortwave，USW）治疗对鼠断尾再植后血管危象的影响及作用机制。方法动物实验从2009年10月至2010年6月实施。取3个月龄雌性成年sD大鼠80只，体质量232．8-289．6g，完全随机化分为5组。各组保留尾侧静脉、尾骨后断离尾，空白组结扎尾动脉；对照组、罂粟碱组、USW高剂量组、USW低剂量组均吻合尾动脉，建立断尾再植模型。术后对照组正常饲养管理，不给任何治疗措施。罂粟碱组术后立即腹腔内注射稀释的盐酸罂粟碱注射液。USW高剂量组、USW低剂量组术后20min立即给予局部吻合口处USW治疗，此后每天1次，至术后5d。USW高剂量组USW剂量：3档，50mA，20min。USW低剂量组剂量：2档，28mA，20min。术后观察鼠尾成活情况至术后10d。手术前后测鼠尾吻合口近远侧皮温差并计算术后与术前的变化值。术前从内眦及术后第8小时从尾尖各采血1次，测血浆内皮素（endothelin，ET）浓度并比较。结果鼠尾成活率：所有鼠分2组，断尾组（空白组）0％（0／14），断尾再植组（对照组-usw低剂量组）44％（29／66），组问差异有统计学意义（P〈0．05）。5组鼠尾成活率分别为0％（0／14）、36．4％（8／22）、57．1％（8／14）、22．2％（4／18）、75．0％（9／12），总体比较差异有统计学意义（P〈0．05）。断尾再植的各组（对照组、罂粟碱组、USW高剂量组、USW低剂量组）总体比较差异有统计学意义（P〈0．05）。断尾再植各组两两比较：USW低剂量组〉对照组，USW低剂量组〉USW高剂量组，罂粟碱组〉USW高剂量组，差异均有统计学意义（P〈0．05）；余2组间差异无统计学意义（P〉0．05）。术前鼠尾皮温差两两比较差异均无统计学意义（P〉0．05）。术后第8小时、5天、6天及7天鼠尾皮温差变化值各组差异均有统计学意义（P〈0．05）。两两比较：其中术后第8小时，USW高剂量组〈对照组。术后第5天，USW高剂量组〈罂粟碱组。术后第6天，USW高剂量组〈空白组、对照组、罂粟碱组。术后第7天，空白组、USW低剂量组〈对照组、罂粟碱组，USW高剂量组〈对照组，差异均有统计学意义（P〈0．05）。其余各组间两两比较差异均无统计学意义（P〉0．05）。术前各组血浆ET含量差异无统计学意义（P〉0．05）。术后第8小时，ET减少量总体比较：USW低剂量组〉罂粟组〉USW高剂量组〉对照组〉空白组，P=0．004。两两比较：USW低剂量组、罂粟碱组与空白组、对照组，USW高剂量组与对照组，差异有统计学意义；余差异均无统计学意义。结论实验大鼠断尾再植模型可行。USW治疗，能提高鼠断尾再植存活率，在术后第8小时、5天、6天、7天，能减小皮温差，减少术后第8小时的ET浓度，防治血管危象。

Effects of ultra-short wave therapy on endothlin of anastomotic site after rat tail replantation

Objective To explore the effects and mechanism of ultra-short wave（USW） for prevention and treatment of vascular crisis after rat tail replantation. Methods The animal experiments were carried out from October 2009 to June 2010. Eighty 3-month old female Sprague Dawley rats （weighing 232.8-289.6 g） were randomly divided into five groups. In each group, based on the caudal vein and the coccyx was retained, the tail was cut off. The tail artery was ligation in Blank group. The tail artery were anastomosed in Control group, Papaverine group, USW high dose group and USW low dose group group to establish the tail replantation model. After surgery, the rats of the Papaverine group were immediately given papaverine hydrochloride injection. The rats of the USW high dose group and the USW low dose group were immediately given the local USW treatment at anastomotic site within postoperative twenty minutes, once a day thereafter, for 5 days at the dosage of three tranche and 50 mA for 20 min（high dose group） and two tranche and 28 mA for 20 min（low dose group）. The survival of the rat tails was observed after the tail replantation for 10 days. The difference between proximal and distal anastomosis site tail skin temperature were measured before and after the replantation; the change between postoperative and preoperative temperature difference was calculated. From the inner canthus before the replantation and from the collected blood plasma specimens and measured contents tip of the tail at postoperative 8th hour, rats were of endothelin. Results The survival rates of the rat tails were 0%（0/14） and 44% （29/66）in the tails cutting off group （Blank group） and the tail replantation group （Control group, Papaverine group, USW high dose group, USW low dose group） respectively, showing significant difference among two groups （5（2=9.649, P=-0.002）. The survival rates of the rat tails were 0%（0/14）, 36.4%（8/22）, 57.1%（8/14）, 22.2%（4/18）, 75.0%（9/12） in groups Blank, Control, Papaverine, USW high dose and USW low dose respectively, showing significant over all differences among 5 groups （χ2=19.935, P=0.001）. The differences showed significant among the tail replantation groups （Control, Papaverine, USW high dose, USW low dose）： （χ2=9.650, P=0.022）. Pairwise comparisons among the tail replantation groups： USW low dose group〉Control, USW low dose group〉USW high dose group, Papaverine group〉USW high dose group, the differences were statistically significant （P〈0.05）, but significant difference wasn＇t found between the other groups （P〉0.05）. Before the replantation, there were no significant difference in tail skin temperature difference between the groups （P〉0.05）. At 8th hour, 5th, 6th and 7th day after the replantation, significant overall difference was found in the change of the skin temperature difference between the groups （P〈0.05）. The pairwise comparison showed significant differences after the replantation （P〈0.05）： Control group〉USW high dose group at 8th hour. Papaverine group〉USW high dose group at 5th day, groups Blank, Control and Papaverine〉USW high dose group at 6th day, groups Control and Papaverine〉groups Blank and USW low dose, and Control group〉USW high dose group at 7th day, no significant difference was found between the other groups at the other time （P〉0.05）. Preoperative plasma ET content between the groups hadn＇t significant difference（P〉0.05）. The overall difference was statistical significant in the difference between preoperative and postoperative the ET content among groups （P〈0.05）： USW low dose group〉Papaverine group〉USW highdose group〉Control group〉Blank group, P=-0.004. Significant differences were found by pairwise comparison （P〈0.05）： groups Papaverine and USW lowe dose〉groups Blank and Control, USW high dose group〉Blank group. Remaining pairwise comparisons between the other groups had no statistical significance（P〉0.05）. Conclusion USW therapy, especially USW low-dose therapy, can reduce vascular crisis and improve the survival rate of replanted rat tails, after the postoperative 8th hour, 5th, 6th, 7th day, reduce skin temperature, improve blood supply, reduce endothelin at postoperative 8th hour, prevent vascular crisis. Rat tail replantation model in this experiment is feasible.