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目的探索低分子量肝素钠改善皮瓣血液循环的机制。方法将48只 Wistar 大鼠随机分为实验组(外用低分子量肝素钠乳膏)和对照组(外用凡士林),每组24只。在大鼠背部设计蒂在头侧的随意型皮瓣(蒂宽2 cm,长8 cm),各组大鼠皮瓣分别外涂相应药物,观察大鼠皮瓣成活情况,分别在术后不同时间(24、48、72 h 和7 d)取血检测一氧化氮,并对皮瓣进行组织形态学检查。结果(1)一氧化氮含量变化:术后7 d,实验组(53±15)μmol/L 高于对照组(27±20)μmol/L(P<0.05);(2)实验组皮瓣存活率(66%±18%)高于对照组(22%±16%),差异有统计学意义(t=18.19,P<0.01);(3)组织学结果显示,实验组皮瓣中新生血管大量形成,而且毛细血管内膜较完整,细胞肿胀轻,线粒体结构较稳定。结论低分子量肝素钠乳膏可以增加皮瓣血液循环中一氧化氮含量,促进皮瓣成活。
Objective To explore the mechanism of low molecular weight heparin sodium to improve blood circulation of flaps. Methods 48 Wistar rats were randomly divided into experimental group (external use low molecular weight heparin sodium cream) and control group (external use petrolatum), 24 rats in each group. On the dorsal side of the rat, a random flap (2 cm in width and 8 cm in length) pedicled on the head was designed. The corresponding flap was applied to the flaps of rats to observe the survival of the flap in rats. Time (24,48,72 h and 7 d) blood to detect nitric oxide, and the flap for histological examination. Results (1) Changes of nitric oxide content: The experimental group (53 ± 15) μmol / L was higher than the control group (27 ± 20) μmol / L on the 7th day after operation The survival rate (66% ± 18%) was higher than that of the control group (22% ± 16%), the difference was statistically significant (t = 18.19, P <0.01) The formation of large numbers of blood vessels, and more complete capillary capillaries, cell swelling, mitochondrial structure more stable. Conclusion Low molecular weight heparin sodium cream can increase the content of nitric oxide in the blood circulation and promote the flap survival.