【摘要】 目的 探討中成藥參附注射液對大鼠深Ⅱ度燒傷創面愈合的影響。 方法 選用16只Sprague-Dawley（SD）大鼠，隨機分為實驗組、對照組，每組各8只，建立20%體表面積深Ⅱ度燙傷模型。燙傷后即刻及此后每天，實驗組大鼠以參附注射液20 mL/kg腹腔注射給藥，1次/d，連續給藥5 d；對照組給予注射等劑量的生理鹽水。分別于致傷后的7、14 d取創面組織塊，光學顯微鏡觀察成纖維細胞及膠原纖維生長情況，電子顯微鏡觀察致傷后14 d成纖維細胞細胞器情況，分別計算燒傷后第7、14天兩組的創面愈合率，并觀察比較兩組創面愈合的時間。 結果 所有選入實驗的SD大鼠均存活至實驗結束。實驗組、對照組術后第7天創面愈合率分別為（36.34±2.55）%及（33.13±2.62）%，兩組差異有統計學意義（t=2.486，P=0.027）；實驗組、對照組術后第14天創面愈合率分別為（75.71±2.29）%及（72.36±2.85）%，兩組差異有統計學意義（t=2.590，P=0.022）；實驗組、對照組創面愈合時間分別為（20.88±1.36）、（22.94±2.16） d，兩組差異有統計學意義（t=-2.286，P=0.0395）。傷后7、14 d創面組織塊切片光學顯微鏡觀察發現，實驗組肉芽組織及膠原纖維較多，排列更有序，表皮基底細胞增殖活躍，炎癥反應較輕；傷后14 d時電子顯微鏡觀察發現，實驗組成纖維細胞的細胞器更豐富，分泌膠原更多，實驗組創面愈合情況優于對照組。 結論 腹腔注射參附注射液可以促進燒傷創面的愈合，其可能的機制為清除氧自由基，抗脂質過氧化。【Abstract】 Objective To explore the effect of Shenfu injection on promoting healing of deep partial-thickness burn wound in rats. Methods Sixteen Sprague-Dawley (SD) rats were randomly selected, and deep partial-thickness burn with 20% of the body surface was inflicted. The rats were randomly divided into experimental group and control group with eight in each group. Rats in the experimental group were treated with abdominal injection of Shenfu injection at a dose of 20 mL/(kg?d) for five days continually, and rats in the control group were treated with the same dose of 0.9% saline solution. The growth of granulation tissue and collagen fibers were evaluated under light microscope at the seventh and the fourteenth day. The growth of fibroblast was observed under transmission electron microscope at the fourteenth day. The cure rate of both groups of rats at the seventh and fourteenth day was calculated. Then we compared their healing time and the cure rate of the traumatic wound respectively. Results All rats had survived until wound healing. The cure rate at the seventh day for the experimental group and the control group was (36.34±2.55)% and (33.13±2.62)%, and their difference was statistical (t=2.486, P=0.027); At the fourteenth day, the cure rate was respectively (75.71±2.29)% and (72.36±2.85)% with a significant difference between each other (t=2.590, P=0.022). The healing time of the experimental group (20.88±1.36) was significantly shorter than that of the control group (22.9±2.16) (t=-2.286, P=0.040). At the seventh and fourteenth day, light microscope observation showed that the growth of granulation tissue and collagen fibers for rats in the experimental group were much more than that in the control group, the basale cell proliferation was more active, and inflammation was slighter. Through transmission electron microscope, we observed more fibroblast and collagen in the experimental group, which showed a better cure than the control group. Conclusion Shenfu injection can significantly promote wound healing of deep partial-thickness burn. It may possibly get this effect through anti-oxidation.
Objective To investigate the effects of glutathione (GSH) on survival of the random skin flap in rats and the probable mechanism that contribute to this effect. Methods Twenty SD rats with 200-250 g in weight, were randomly divided into the experimental group and control group(n=10). Random flap of 8 cm×2 cm in size was made on the back of each rat with the pedicel on the angular of the scapular. GSH(250 mg/kg) and NS of the same dose were injected into the abdominal cavity of rats in the experimental groupand the control group immediately after the operative, 1st and 2nd days respectively. The rats were killed on the 7th day after the operation. The tissue pathology, the survival rate of the flap, the superoxide dismutase(SOD) activity and malonyldialdehyde (MDA) level were compared between two groups. Results The mean survival rate of the flap on the 7th day in the experimental group（56.77%±10.67%） was higher than that in the control group(40.16%±7.12%)(Plt;0.05).SOD activity in experimental group （306.06±84.87 U/mgprot）was higher than that in the control group （224.79±27.12 U/mgprot）, while MDA level （3.835±0.457 nmol/mgprot）was lower than that in the control group (6.127±0.837 nmol/mgprot)(Plt;0.05). Histological observation showed that the neutrophil infiltration was less in experimental group than that in the control group; that the experimental group was surperior to the control group in angiogenesis, fibroblasts, fair cells and cuaneous gland. Conclusion The intraperitoneal use of GSH may promote the survival rate of the random flaps and the possible mechanism for improvement may lies in that the GSH can reduce the level of oxygen free radical and lipidperoxidation,and lessen neutrophil infiltration.
Objective To investigate the effectiveness of high frequency color Doppler ultrasound for detecting perforators in the anterolateral thigh (ALT) flap surgery. Methods Between February 2011 and July 2012, 8 patients underwent high frequency color Doppler ultrasound to detect the perforator anatomy before ALT flap surgery. There were 5 males and 3 females, aged 21-46 years (mean, 34 years). Defects were caused by excision of squamous cell carcinoma in 2 cases, by scalp avulsion in 2 cases, by soft tissue necrosis after neck trauma in 1 case, by excision of groin fibrosarcoma in 1 case, by excision of groin melanoma in 1 case, and by malformation of the face in 1 case. The defect size varied from 12 cm × 7 cm to 22 cm × 18 cm. The perforator with wider caliber, faster flow speed, and shorter intramuscular trajectory was selected, and the flap was designed according to the observed results, which size varied from 14 cm × 9 cm to 25 cm × 20 cm. The donnor sites were repaired by free skin graft. Results Totally, 19 perforators in the flap area were detected by high frequency color Doppler ultrasound, and 18 were identified during operation, with an accuracy rate of 94.7%. The point going out muscle, the travel and direction of perforators observed during operation were basically in accordance with those detected by high frequency color Doppler ultrasound. The other flaps survived, and obtained healing by first intention except 1 flap which had partial fat necrosis with healing by second intention. The skin graft at donor site survived. All patients followed up 4-16 months (mean, 8 months). The flaps had good color and texture. Conclusion High frequency color Doppler ultrasound is a valuable imaging modality for the preoperative assessment of the vascular supply for ALT flap.