选择性COX-2抑制剂对大鼠断肢再植术后成活率影响的实验研究

Experimental study on effect of selective COX-2 inhibitor on survival rate of rats after replantation of severed limb

目的研究选择性COX-2抑制剂帕瑞昔布钠对断肢再植术后吻合血管及其成活率的影响,探究其再植术后镇痛治疗中的安全性。方法实验选用成年SD大鼠共60只,雄性,随机分为3组,安慰剂组、对照组、治疗组,分别把左侧大腿中上1/3水平环形离断,然后再将断肢进行再植,对照组用吗啡注射液,治疗组用帕瑞昔布钠镇痛,术后连续给予3 d,并术后3 d、5 d、7 d、10 d观察肢体成活情况,并根据血管造影及显微镜下观察吻合血管的通畅及血栓等情况。结果 60例大鼠断肢再植术后出现断肢坏死,治疗组1例,对照组2例,安慰剂组5例,其余均成活。对照组及治疗组成活率比较差异无统计学意义(P>0.05),但与安慰剂组比较差异均有统计学意义(P<0.05)。成活肢体血管吻合口处内膜生长良好,吻合口通畅,无血栓形成。结论帕瑞昔布钠对大鼠断肢再植术后治疗不影响对吻合血管通畅,不损伤内膜,未增加血栓形成,可提高断肢成活率。

Objective To study the effects of selective COX-2 inhibitor parecoxib sodium on after replantation of severed limb vascular anastomosis and the survival rate,and explore the safety of replantation in analgesia treatment. Methods A total of 60 adult male SD rats,,were randomly divided into 3 groups： control group,treatment group and control group,respectively,the left leg in the 1 /3 level ring from the break,and then replant limbs,the control group with morphine injection,treatment group with parecoxib sodium analgesia. Observation of limb survival situation after continuous administration of 3 days,and after 3 days,5 days,7 days,10 days,according to the angiography and observation under the microscope and thrombosis and vascular anastomosis patency and so were conducted. Results 60 cases of rats after replantation of severed limbs appeared limb necrosis,1 case in the treatment group,2 cases in the control group,5 patients in the placebo group,the others survived. Difference of survival rate of group 2 and group 3 had no statistically significant（ P〈0. 05）,when compared with the group 1 had significant difference（ P〈0. 05）. The survival of extremity vascular anastomotic neointimal growth well,anastomotic patency,thrombus formation. Conclusion Parecoxib sodium on rat after replantation of severed limb treatment did not affect on vascular anastomosis patency,did not damage the endometrium,nor did increase in thrombosis,which can increase the survival rate of amputation.