烧烙与鸦胆子软膏在马体表肿瘤切除术中的应用体会

Application of cautery and Frucuus Bruceae ointment in resection of surface tumors in horses

肿瘤是由于邪毒结聚、脏腑失调而引起异常生长的赘生物,体表肿瘤一般以外治为主。为防止良性肿瘤受到刺激恶化及恶性肿瘤的发展转移,尤其是对性质判定不明的体表肿瘤,通过手术摘除仍然是兽医临床最有效的治疗方法。而常规的手术方法并不适合马四肢体表肿瘤的根治,特别是体积比较大的肿瘤。2例患马,经初步诊断为良性肿瘤,疑为纤维瘤。采用在瘤体根部与皮肤表面持平的平切术式切除肿瘤;因在肿瘤的间质内富含大量的血管与机体相通,所以在较大的切面上出现多量出血点,表现为混合性出血的特点;同时若未将病变组织彻底清除,存有复发的风险。故在手术中使用烧烙疗法和鸦胆子软膏外敷。用烧至黑红色的烙铁在出血创面进行浅层烧烙,形成焦黄色烙痂,达到快速止血、破坏肿瘤组织、保护创面的作用。中药鸦胆子籽仁外敷有腐蚀疣瘤、清除赘瘤的功效,为防止残留的肿瘤组织再次生长,选取质坚、仁白、油性足的鸦胆子籽粒,去皮壳取仁,研磨成糊状软膏,外敷于创面,压迫绷带包扎。手术切除的瘤体质量分别为1660 g、704 g,均为膨胀性生长,包膜完整、质地坚韧、切面色灰白、半透明,有放射状水波纹等。换药3~5次,配合对症治疗等措施,2例患马均获痊愈,患部与正常皮肤无异且未复发。

Tumors are vegetations that grow abnormally due to the accumulation of pathogenic toxins and the disorder of viscera.The treatment of body surface tumor is generally based on external treatment.In order to prevent the deterioration of benign tumors by stimulation and the development and metastasis of malignant tumors,especially the surface tumor whose nature is unknown,surgical resection is still the most effective treatment in veterinary clinic.However,conventional surgical resection methods are not suitable for radical treatment of limb surface tumors in horse,especially for large tumors.Two cases of horses were initially diagnosed as benign tumors,and fibroma was suspected.The tumor was resected by horizontal resection at the root of the tumor body and the skin surface.Due to a large number of blood vessels communicating with the body in the interstitium of the tumor,a large number of bleeding spots appeared on the larger section,showing the characteristics of mixed bleeding.At the same time,the diseased tissue is not completely removed,there is a risk of recurrence.Therefore,cautery and Frucuus Bruceae ointment were used in the operation.The bleeding wound was burned in a shallow layer with a black and red iron to form a burnt yellow scab,so as to achieve rapid hemostasis,destroy tumor tissue and protect the wound.Frucuus Bruceae has the effects of corroding tumor and removing tumor.In order to prevent the residual tumor tissues grow again,the good Frucuus Bruceae was seleceted and the skin and shell were removed.The gotten kernels were made into ointment.The ointment was applied externally to the wound and the compression bandage was applied.The weight of the two tumors removed by surgery was1660 g and 704 g,both of them were expansible,with complete capsule,tough texture,pale complexion,translucent color,and radial water ripples.After dressing change for 3 to 5 times and symptomatic treatment,the two horses were cured.And the affected parts had no difference from normal skin and no recurrence was observed.