超短波治疗大鼠断尾再植后血管危象的实验研究

EXPERIMENT STUDY ON ULTRASHORT WAVE FOR TREATING VASCULAR CRISIS AFTER RAT TAIL REPLANTATION

目的探讨超短波(ultrashort wave,USW)对鼠断尾再植后血管危象的影响及作用机制。方法取3月龄雌性SD大鼠80只,体重232.8～289.6 g,随机分为5组。各组保留尾侧静脉、尾骨后断离鼠尾,A组结扎尾动脉;B、C、D、E组均吻合尾动脉,建立断尾再植模型。术后B组正常管理;C组立即按3.125 mL/kg剂量腹腔注射稀释的盐酸罂粟碱注射液(1 mg/mL)。D、E组立即给予局部吻合口处USW治疗(1次/d),至术后5 d,D组剂量:3档,50 mA,20 min;E组剂量:2档,28 mA,20 min。术后观察鼠尾成活情况至10 d;手术前后测鼠尾吻合口近远侧皮温差并计算术后与术前的变化值;术前从内眦及术后8 h从尾尖各采血1次检测血浆一氧化氮(nitric oxide,NO)浓度并进行比较。结果术后7 d A、B、C、D、E组鼠尾成活率分别为0(0/14)、36.4%(8/22)、57.1%(8/14)、22.2%(4/18)、75.0%(9/12),组间比较差异有统计学意义(χ2=19.935,P=0.001);E组成活率显著高于B组(P<0.05),其余各组两两比较差异均无统计学意义(P>0.05)。术前各组间鼠尾皮温差比较差异均无统计学意义(P>0.05)。术后8 h、5 d、6 d及7 d各组间比较鼠尾皮温差变化值差异均有统计学意义(P<0.05),其中术后8 h B组皮温差变化值大于D组(P<0.05);术后5 d C组大于D组(P<0.05);术后6 d A、B、C组均大于D组(P<0.05);术后7 d A、E组低于B、C组(P<0.05),D组低于B组(P<0.05);其余各组间两两比较差异均无统计学意义(P>0.05)。术前各组血浆NO含量差异无统计学意义(P>0.05)。术后8 h A、B、C组血浆NO含量显著低于D组(P<0.05),手术前后变化值A、B组显著低于D组(P<0.05);其余各组间两两比较差异均无统计学意义(P>0.05)。结论实验中大鼠断尾再植模型可行。USW治疗能提高鼠断尾再植成活率,在术后7 d内能减小皮温差,提高术后早期NO浓度,防治血管危象。

Objective To explore the effect and mechanism of ultrashort wave （USW） for prevention and treatment of vascular crisis after rat tail replantation. Methods Eighty 3-month old female Sprague Dawley rats （weighing 232.8- 289.6 g） were randomly divided into 5 groups. In each group, based on the caudal vein and the coccyx was retained, the tail was cut off. The tail artery was ligated in group A; the tail artery was anastomosed in groups B, C, D, and E to establish the tail replantation model. After surgery, the rats of group B were given normal management; the rats of group C were immediately given intraperitoneal injection （3.125 mL/kg） of diluted papaverine hydrochloride injection （1 mg/mL）; the rats of groups D and E were immediately given the local USW treatment （once a day） at anastomotic site for 5 days at the dosage of 3 files and 50 mA for 20 minutes （group D） and 2 files and 28 mA for 20 minutes （group E）. The survival rate of the rat tails was observed for 10 days after the tail replantation. The tail skin temperature difference between proximal and distal anastomosis was measured at pre- and post-operation; the change between postoperative and preoperative temperature difference was calculated. The blood plasma specimens were collected from the inner canthus before operation and from the tip of the tail at 8 hours after operation to measure the content of nitric oxide （NO）. Results The survival rates of the rat tails were 0 （0/14）, 36.4% （8/22）, 57.1% （8/14）, 22.2% （4/18）, and 75.0% （9/12） in groups A, B, C, D, and E, respectively, showing significant overall differences among 5 groups （χ2=19.935, P=0.001）; the survival rate of group E was significantly higher than that of group B at 7 days （P 〈 0.05）, but no significant difference was found between the other groups by pairwise comparison （P 〉 0.05）. At preoperation, there wasno significant difference in tail skin temperature difference among 5 groups （P 〉 0.05）; at 8 hours, 5 days, 6 days, and 7 days after operation, significant overall difference was found in the change of the skin temperature difference among groups （P 〈 0.05）; pairwise comparison showed significant differences after operation （P 〈 0.05）： group B 〉 group D at 8 hours, group C 〉 group D at 5 days, groups A, B, and C 〉 group D at 6 days, groups B and C 〉 groups A and E, and group B 〉 group D at 7 days; but no significant difference was found between the other groups at the other time points （P 〉 0.05）. Preoperative plasma NO content between each group had no significant difference （P 〉 0.05）. The overall differences had significance in the NO content at postopoerative 8 hours and in the change of the NO content at pre- and post-operation among groups （P 〈 0.05）. Significant differences were found by pairwise comparison （P 〈 0.05）： group D 〉 groups A, B, and C in the plasma NO content, group D 〉 groups A and B in the change of the NO content at pre- and post-operation; but no significant difference was found between the other groups by pairwise comparison （P 〉 0.05）. Conclusion Rat tail replantation model in this experiment is feasible. USW therapy can increase the survival rate of replanted rat tails, reduce skin temperature at 7 days, improve blood supply, increase the content of nitric oxide at the early period and prevent vascular crisis.