低分子肝素和重组水蛭素对兔耳静脉淤血皮瓣成活的影响

背景:低分子肝素和水蛭素都有活血化淤作用。目的:观察局部注射低分子肝素或重组水蛭素对静脉淤血皮瓣成活的影响。方法:在24只兔左耳背制作3cm×6cm静脉淤血皮瓣模型,随机分组:对照组皮瓣下多点注射生理盐水;肝素组皮瓣下多点注射低分子肝素625U/mL,水蛭素组皮瓣下多点注射重组水蛭素1U/mL。结果与结论:①大体观察:术后水蛭素组和肝素组较对照组淤血程度轻,血肿消散快。②皮瓣成活面积百分比:水蛭素组、肝素组明显高于对照组(P<0.01),水蛭素组和肝素组比较差异无显著性意义(P>0.05)。③苏木精-伊红染色结果:对照组术后同期微血管淤血程度较水蛭素组和肝素组严重,微血管计数明显少于水蛭素组和肝素组(P<0.05,P<0.01),水蛭素组微血管计数明显高于肝素组(P<0.01)。说明局部应用低分子肝素或重组水蛭素可较快改善皮瓣的淤血,提高皮瓣成活,重组水蛭素效果优于低分子肝素。

Influence of low-molecular-weight heparin or recombinant hirudin on the survival of ear venous congested skin flap of rabbits

BACKGROUND:Low-molecular-weight heparin(LH) and recombinant hirudin(RH) can promote blood circulation.OBJECTIVE:To investigate the effect of local injection of LH or RH on the survival of venous congested skin flap.METHODS:Twenty-four rabbits were employed to use the 3 cm×6 cm venous congested skin flap model on the back of left ear.The models were randomly divided into three groups:the control group was performed with multi-point injection of saline under skin flap;LH group was performed with multi-point injection of 625 U/mL LH under skin flap;RH group was multi-point injected with 1 U/mL RH under skin flap.RESULTS AND CONCLUSION:① General observation showed that the congestion in RH group and LH group was lighter than that in control group,and the hematoma dissipate quickly in RH group and LH group.② The percentage of flap survival area in RH group and LH group was higher than that in the control group obviously(P < 0.01),there was no significant difference between RH group and LH group(P > 0.05).③ Hematoxylin-eosin staining showed that congestion of microvascular in control group after operation was more serious than that in the RH group and LH group(P < 0.05,P < 0.01),the number of microvascular in RH group was higher than that in the LH group(P < 0.01).Local application of LH and RH can improve the congestion of skin flap,inhibit the survival rate of flap.There was better effect of using RH than LH.