低分子量肝素钠软膏对大鼠随意型皮瓣一氧化氮的影响

Effect of low molecular heparin sodium cream on the content of serum nitric oxide in random pattern skin flap:experiment with rats

目的探索低分子量肝素钠改善皮瓣血液循环的机制。方法将48只 Wistar 大鼠随机分为实验组(外用低分子量肝素钠乳膏)和对照组(外用凡士林),每组24只。在大鼠背部设计蒂在头侧的随意型皮瓣(蒂宽2 cm,长8 cm),各组大鼠皮瓣分别外涂相应药物,观察大鼠皮瓣成活情况,分别在术后不同时间(24、48、72 h 和7 d)取血检测一氧化氮,并对皮瓣进行组织形态学检查。结果(1)一氧化氮含量变化:术后7 d,实验组(53±15)μmol/L 高于对照组(27±20)μmol/L(P<0.05);(2)实验组皮瓣存活率(66%±18%)高于对照组(22%±16%),差异有统计学意义(t=18.19,P<0.01);(3)组织学结果显示,实验组皮瓣中新生血管大量形成,而且毛细血管内膜较完整,细胞肿胀轻,线粒体结构较稳定。结论低分子量肝素钠乳膏可以增加皮瓣血液循环中一氧化氮含量,促进皮瓣成活。

Objective To explore the mechanism of improvement of blood circulation in random pattern skin flap by low molecular heparin sodium cream. Methods 48 Wistar rats underwent formation of random skin flap of the size of 2 cm × 8 cm on the back and then were randomly divided into 2 equal groups ： experiment group with low molecular heparin sodium cream smeared on the skin flaps and control group with Vaseline smeared on the skin flaps. 24, 48, and 72 hours, and 7 days after the smearing blood samples were collected from 6 rats respectively to detect the content of serum nitric oxide a（NO）. Seven days after the smearing specimens were collected from the upper, middle, and lower parts of the skin flaps to undergo pathological examination. Results （ 1 ） The serum NO content of the experiment group was （ 53 ± 15 ） μmol/L, significantly higher than that of the control group [ （27 ± 20） μmol/L,P 〈 0. 05 ] 7 days after the operation. （2）The skin flap survival rate of the experiment group was （66 ± 18） %, significantly higher than that of the control group [ （22 ±16）%, P 〈 0. 01 ]. （3） Histomorphology showed formation of neo-vessels with integrated endangium of capillary, stability of structure of mitochondria, and milder cell swelling in the flaps treated with heparin cream. Conclusion Low molecular heparin sodium cream increases the content of serum NO, thus increasing the survival of skin flaps.