高压氧与地塞米松对大鼠真皮下血管网皮瓣愈合的影响

The effects of dexamethasone and hyperbaric oxygen on the survival of subdermal vascular networks

目的研究应用高压氧(HBO)和地塞米松(DEX)对大鼠真皮下血管网(SVN)皮瓣愈合的影响,以及二者的协同作用。方法将Wistar大鼠40只随机分为对照组、DEX组、HBO组和DEX+HBO组。于背部制备2.5 cm×10 cm SVN皮瓣。于术后第7天观察各皮瓣的成活面积,皮瓣横断面的肉芽组织生长厚度、毛细血管数量以及中性粒细胞浸润情况等。结果4组大鼠术后第7天,皮瓣的成活面积分别为7.90,10.48,15.53,15.58 cm^2,DEX组、HBO组和DEX+HBO组与对照组比较,差异有统计学意义(P<0.01),HBO组和DEX+HBO组与DEX组比较差异有统计学意义(P<0.01),HBO组和DEX+HBO组组问差异无统计学意义(P>0.05)。结论HBO与DEX单独应用时,均对大鼠SVN皮瓣的愈合有促进作用,且HBO优于DEX,二者联合应用亦可促进SVN皮瓣的愈合,但与HBO单独应用无明显差别。

Objective To study the effects of dexamethasone （DEX） and/or hyperbaric oxygen （HBO） on the subdermal vascular network （SVN）. Methods SVNs were selected on dorsal skin flaps of 40 Wistar rats. The animals were divided randomly into a control group, a DEX group, a HBO group and a HBO ＋ DEX group. Cranially based, 2.5 cm × 10 cm dorsal SVN skin flaps were sharply incised and elevated between the dartos and SVN, then sutured to their beds. On the 7th postoperative day, the surviving flap area was measured along with the number of new capillary, the thickness of meat tissue and the number of infiltrated neutrophilic granulocytes in the SVN skin flap. Results The mean surviving flap area for the control group was 7. 90 cm2, for the DEX group it was 10.48 cm2, for the HBO group 15.53 cm2, and for the DEX ＋HBO group it was 15.58 cm2. The improvement in surviving flap area was highly statistically significant compared with the control. The improvement was also statistically significant when the HBO group or HBO ＋ DEX group was compared with the DEX group. However, no statistically significant difference was found between the HBO group and HBO ＋ DEX group. Conclusion in a rat dorsal skin flap model, DEX or HBO improved skin flap viability, but DEX alone is not as efficacious as HBO or as DEX ＋ HBO. DEX plus HBO showed no additive beneficial effect over HBO alone.