预防长春新碱静注致血管损伤的实验研究

Research on Preventive Measures Against Phlebitis Caused by Vincristinum with Intravenous Injection

目的 观察不同方法静注长春新碱对兔耳缘静脉的影响,为临床预防药物性静脉炎提供依据。方法 将20只健康新西兰白兔随机分为4组,即常规光镜组（A1）、实验光镜组（A2）、常规电镜组（A3）、实验电镜组（A4）;所有动物古耳缘为实验组,左耳均为对照组,A1、A3以等量的生理盐水为对照（B1、B3）,A2、A4以常规注射方法为对照（B2、B4）。常规组以60ml生理盐水先导后冲法,实验组采用回抽冲洗法,光镜、电镜下观察穿刺静脉的病理变化。结果 A1、B2可见血管内皮细胞大部分消失,纤维组织增生,部分管壁增厚,内壁可见小血栓形成;A2血管大部分区域内衬单层扁平上皮,小部分血管内皮细胞增生,管壁略增厚。A3、B4内皮细胞核浓缩,可见大小不等小泡状结构,胞浆内细胞器结构不清;A4内皮细胞膜结构清晰,核染色质颗粒密度稍增高均匀分布,胞浆内见少许线粒体及内质网膜结构清晰。结论 A2较B2、A4较B4损伤明显减轻,回抽冲洗法较常规法预防药物性静脉炎更为有效。

Objective To observe the influence of intravenous injection of vincristinum on marginal veins of rabbit's ear to prevent clinical phlebitis. Methods Twenty rabbits were randomly divided into four groups: control microscopic control (A1), study microscopic group(A2), control transmission electron microscopic group(A3),and study transmission electron microscopic group(A4). A1 and A3 control groups used the left ears,using the same volume of isotonic saline as control(B1 and B3). The control groups of A2 and A4 study groups used the right ears, using the usual methods as control (B2 and B4). Control groups used 60ml isotonic saline by usual methods,and study groups used the drawing-and-pushing method. Pathologic changes were observed using light microscope and transmission electron microscope. Results: Most of the endothelium disappeared in A1 and B2 groups and hyperplasia of fiber , thickened tube walls and thrombotic vasculum were observed. In A2 group,most of the endothelium was normal and there were lightly thickened tube walls and light hyperplasia of fiber. In A3 and B4 groups,dense nuclei in endothelium and some bubbles and harmed structure were observed. In A4 group,the membrane in endothelium was normal,and there was slightly dense nuclei and some mitochondria. Conclusion Compared with B2 and B4 groups, A2 and A4 groups showed lighter harm,suggesting that the drawing-and-pushing method is better than the usual one.