CAJ | 학술논문

目的研制一种自制的血管内止血带,并进行动物实验,探讨血管内止血带止血的效果及其安全性.方法随机将40只大白兔分为4组:A组16只,持续阻断右侧颈总动脉1h;再分为A1、A2、A3、A4亚组,每组4只,分别于血管内止血带置入后1h、5、14、21 d取右颈总动脉与球囊接触动脉标本,分别送作血管组织匀浆,酶联免疫吸附试验(ELISA)法检查半胱氨酰天冬氨酸特异性蛋白酶(Caspase)-3浓度、原位缺口末端标记法(TUNEL)法检测细胞凋亡数.B组16只,持续阻断右侧颈总动脉2h,检查项目同A组.C组,空白对照组4只,不插入血管内止血带,检查项目同A组.D组,假手术组4只,切开皮下各层暴露右颈总动脉后1h,检查项目同A组.结果 C、D、A1、A2、A3、A4、B1、B2、B3、B4组Caspase-3浓度(μmoL/L)分别为:10.35±0.82、12.22±2.41、11.35±1.63、18.93±1.01、24.30±1.64、15.63±2.43、12.09±0.83、19.36±2.45、26.29±3.30、14.35±3.28;C、D、A1、A2、A3、A4、B1、B2、B3、B4组TUNEL染色阳性数分别为:0.26±0.20、0.29±0.02、0.38±0.03、0.44±0.06、0.59±0.05、0.42±0.07、0.40±0.04、0.54±0.05、0.63±0.08、0.48±0.05.血管内止血带置入术后Caspase-3浓度、凋亡阳性细胞数于术后5d增加,术后14 d达高峰,术后21 d仍处于较高水平;血管内止血带置入术后B组分别与同时段A组比较,B组Caspase-3浓度和凋亡阳性细胞数高于A组(P＜0.05).结论血管内止血带持续阻断血流不超过2h时安全有效.
목적 연제일충자제적혈관내지혈대,병진행동물실험,탐토혈관내지혈대지혈적효과급기안전성.방법 수궤장40지대백토분위4조:A조16지,지속조단우측경총동맥1h;재분위A1、A2、A3、A4아조,매조4지,분별우혈관내지혈대치입후1h、5、14、21 d취우경총동맥여구낭접촉동맥표본,분별송작혈관조직균장,매련면역흡부시험(ELISA)법검사반광안선천동안산특이성단백매(Caspase)-3농도、원위결구말단표기법(TUNEL)법검측세포조망수.B조16지,지속조단우측경총동맥2h,검사항목동A조.C조,공백대조조4지,불삽입혈관내지혈대,검사항목동A조.D조,가수술조4지,절개피하각층폭로우경총동맥후1h,검사항목동A조.결과 C、D、A1、A2、A3、A4、B1、B2、B3、B4조Caspase-3농도(μmoL/L)분별위:10.35±0.82、12.22±2.41、11.35±1.63、18.93±1.01、24.30±1.64、15.63±2.43、12.09±0.83、19.36±2.45、26.29±3.30、14.35±3.28;C、D、A1、A2、A3、A4、B1、B2、B3、B4조TUNEL염색양성수분별위:0.26±0.20、0.29±0.02、0.38±0.03、0.44±0.06、0.59±0.05、0.42±0.07、0.40±0.04、0.54±0.05、0.63±0.08、0.48±0.05.혈관내지혈대치입술후Caspase-3농도、조망양성세포수우술후5d증가,술후14 d체고봉,술후21 d잉처우교고수평;혈관내지혈대치입술후B조분별여동시단A조비교,B조Caspase-3농도화조망양성세포수고우A조(P＜0.05).결론 혈관내지혈대지속조단혈류불초과2h시안전유효.
Objective To study the effect and safety of a self-made internal tourniquet by experimental studies.Methods 40 rabbits were randomly divided into four groups:group A,16,intravascular tourniquet continuing to block up the right common carotid artery for 1 h; further divided into A1,A2,A3,A4-group (n =4) respectively,1 h,5,14,21 days after the placement of intravascular tourniquet; the right common carotid artery is divided into two sections to be sent for immunohistochemistry [by TdT-mediated dUTP nick end labeling (TUNEL)] and enzyme linked immunosorbent assay (ELISA) examination cysteinyl aspartate-specific protease-3 (Caspase-3) ; In group B,16,intravascular tourniquet continued to block up the right common carotid artery for 2 h; further divided into B1,B2,B3,B4 group (n =4) respectively,the examination is the same as group A.Group C,the blank control group,4,intravascular tourniquet is not placed in the right carotid artery,the examination is the same as group A.Group D,sham operation group 4,expose the right common carotid artery for 1 h,the examination is the same as group A.Results The Caspase-3 concentrations (μmol/L) in group C,D,A1,A2,A3,A4,B1,B2,B3,B4 were 10.35 ±0.82,12.22±2.41,11.35 ±1.63,18.93 ±1.01,24.30±1.64,15.63 ±2.43,12.09± 0.83,19.36 ± 2.45,26.29 ± 3.30,14.35 ± 3.28 respectively ; The apoptotic cells in group C,D,A1,A2,A3,A4,B1,B2,B3,B4 were 0.26 ±0.20,0.29 ±0.02,0.38 ±0.03,0.44 ±0.06,0.59 ± 0.05,0.42 ± 0.07,0.40 ± 0.04,0.54 ± 0.05,0.63 ± 0.08,0.48 ± 0.05 respectively.The Caspase-3 concentrations and apoptotic cells increased after 5 d,reached the peak after 14 d,remained at a high level after 21 d; Caspase-3 levels and apoptotic cells in B group had significant difference compared with those in B group.Conclusion Internal tourniquet is a safe and effective to occlude the blood flow in common carotid artery.