表阿霉素外渗后局部组织损伤处理的实验研究

Experiment about treatment methods of local tissue damage caused by extravasation of epirubicin

目的观察不同药物治疗表阿霉素外渗后局部组织损伤的效果，以寻找理想的处理方法。方法制作2种表阿霉素外渗动物模型，模型Ⅰ为单纯表阿霉素外渗，模型Ⅱ为表阿霉素外渗伴局部组织淤血。对2种局部损伤模型分别用云南白药加50％乙醇湿敷（A疗法），50％的硫酸镁湿敷（B疗法）和2％利多卡因加地塞米松对局部损伤组织环形封闭（C疗法）进行治疗，未给予任何治疗者为对照组，每组各12例。对4组的疗效进行肉眼和组织学观察。结果治疗后第2天，4组间组织损伤比较差异无统计学意义（P〉0．05）。模型Ⅰ第5天，模型Ⅱ第7天局部组织充血水肿、炎性细胞浸润显著消退，模型Ⅱ以云南白药加50％乙醇湿敷组效果最为显著，50％的硫酸镁湿敷对模型Ⅰ有较好疗效，2％利多卡因加地塞米松环形封闭对局部组织淤血消退的疗效较好。模型Ⅱ的病情、组织修复难度重于或大于模型Ⅰ。结论临床处理表阿霉素外渗应根据局部组织损伤的不同特点选择合理有效的方法进行针对性处理。

Objective To make clear the clinical effects for local tissue damage caused by extravasation of epirubicin when cured by different drugs, and then choose certain proper treating methods. Methods Established two animal models： extravasation of epirubicin without any complications in Model Ⅰ , extravasation of epirubicin combined with local congestion in Model Ⅱ. Three methods were introduced to manage local damages： Yunnan white powder and 50% ethanol hydropathic compress （Therapy A）, 50% magnesium sulfate hydropathic compress（Therapy B）, 2% lydocaine and hexadecadrol blocking damaged tisstie in a ring shape （Therapy C）, and the control group received no therapy. Observe and compare local and histological outcomes. Results No significant difference in severity of tissue damage was found among 4 groups after 2 days. Congestion, edema and inflammatory cell infiltration of local tissue were improved significantly after 7 days. Therapy A produced notable effects. Therapy B acquired better effects in managing congestion and edema of local tissue in Modal Ⅰ. Therapy C achieved satisfactory management in Model Ⅱ. Conclusion Different methods on tissue damage caused by extravasation of pharmorubucin should be chosen according to different characteristics of tissue damage.