罗哌卡因与舒芬太尼对创面愈合的影响

发布时间：2018-02-12 03:49

本文关键词： 罗哌卡因舒芬太尼创面愈合 GM-CSF　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:探讨罗哌卡因局部浸润和舒芬太尼腹腔注射对人为制造的小鼠创面进行愈合及其在整个愈合过程中对小鼠粒-巨噬细胞集落刺激因子(GM-CSF)的影响。方法:取健康的并且是清洁等级的雄性非雌性的SD小鼠128只,体重均在20-25g范围之间,应用统计学中规定的随机数字表法,将128只小鼠进行随机分组,结果分为4组(每组数量n=32):空白生理盐水组(NS组),罗哌卡因组(L组),舒芬太尼组(S组),罗哌卡因+舒芬太尼组(L+S组)。将小鼠称重,用0.6%戊巴比妥钠的药品在小鼠的腹部将针头刺入小鼠肚子中进行注射麻醉,对小鼠背部进行脱毛工作,在常规消毒之后,在小鼠背部制作一个0.8cm×0.8cm的近似标准正方形的创面,用眼科剪剪开皮肤的全层,直至皮下部分的致密结缔组织深筋膜部分。于制造创面前的10min,L和L+S组皮下浸润0.5%的局麻药罗哌卡因,剂量为1.0ml/kg,S和L+S组在小鼠腹腔进行注射阿片类镇痛药舒芬太尼,剂量为3.0μg/kg并且均稀释到1.0ml。分别于制造创面的第3,7,10天,每组取出8只小鼠,处死后观察每只小鼠创面的愈合率,取创面处组织进行HE染色病理学检测,ELISA法测定GM-CSF的表达情况,另外用BCA蛋白定量法检测各个标本中总蛋白的含量,用相应的ELISA值与BCA值之比表示GM-CSF含量,将其值进行组间比较,对每组剩余的8只小鼠进行观察,并且记录其完全愈合时间。结果:(1)创面愈合率结果:L组、S组和L+S组小鼠的创面愈合率分别于制造创面的第3、7、10天明显高于NS组结果,并且L+S组的结果高于L组和S组(P0.05),L组和S组的结果进行比较,从统计学角度分析,两组间结果的差别没有明显的意义(P0.05)。(2)病理学观察:L组和S组小鼠制造创面第3天,炎症细胞浸润比NS组少,梭状内皮细胞增殖明显,微血管生成增多。制造创面第7天,肉芽组织及多种细胞增殖旺盛,有小动脉形成。制造创面第10天,小动脉大量增生,毛囊出现,增厚的表皮细胞层几乎覆盖创面。与L组和S组比较,L+S组创面中包含的肉芽组织增生更加明确,表皮细胞爬行更早出现,创面愈合所需的时间相对缩短。(3)GM-CSF检测:NS组小鼠制造创面第3天,GM-CSF含量达到高峰,第7天较第3天稍下降但仍维持较高水平,第10天明显降低;L组和L+S组的GM-CSF含量与NS组结果进行对比,其数值变化的趋势表现出一致性,制造创面的第3,7,10天的GM-CSF含量的数值都呈现出升高的结果(P0.05);S组数值结果与NS组对比,L+S组数值结果与L组对比,分别表现出结果的变化走形基本一致,任意两组间结果的比较,从统计学角度分析,两组间GM-CSF含量的结果之间的差别没有明显的意义(P0.05)。(4)愈合时间:L组创面愈合时间比NS组缩短(2.000±0.000)d,S组创面愈合时间比NS组缩短(1.875±0.330)d,L+S组比L组和S组分别缩短(2.125±0.330)d,(2.250±0.415)d(P0.05)。结论:局部浸润0.5%罗哌卡因和腹腔注射舒芬太尼3.0μg/kg均可促进创面愈合,联合用药效果优于单独使用。
[Abstract]:Objective: to investigate the effect of ropivacaine infiltration and intraperitoneal injection of sufentanil on wound healing in mice and the effect of ropivacaine on granulocyte-macrophage colony stimulating factor (GM-CSF) during the whole healing process. 128 healthy, non-female male Sprague-Dawley mice of clean grade. The body weight was in the range of 20-25 g. 128 mice were randomly divided into two groups by using the random digital table method specified in statistics. Results the rats were divided into 4 groups (n = 32): normal saline group, ropivacaine group, sufentanil group, ropivacaine group, ropivacaine sufentanil group, ropivacaine sufentanil group, ropivacaine sufentanil group, and ropivacaine sufentanil group. 0.6% pentobarbital sodium was used to inject the needle into the abdomen of mice for anesthesia. After routine disinfection, an approximate standard square wound of 0.8 cm 脳 0.8 cm was made in the back of mice. The whole layer of skin was cut open by ophthalmology up to the deep fascia of dense connective tissue in subcutaneous part. The local anesthetic ropivacaine (0.5%) was subcutaneously infiltrated subcutaneously in group L and L S in 10 min before the injury. Intraperitoneal injection of sufentanil (3.0 渭 g / kg) and dilution to 1.0 ml in 1.0 ml / kg / kg and L / L groups were performed respectively on the 3rd day of wound making, 8 mice in each group were taken out, and the wound healing rate of each mouse was observed after death. The expression of GM-CSF in wound tissue was detected by HE staining and Elisa. In addition, the content of total protein in each specimen was detected by quantitative method of BCA protein, and the content of GM-CSF was expressed by the ratio of ELISA value to BCA value, and the value of GM-CSF was compared between groups. The remaining 8 mice in each group were observed, and their complete healing time was recorded. Results the wound healing rate of mice in group S and group L was significantly higher than that in group NS at 710 days after making wounds. The results of group L and group S were higher than those of group L and group S respectively. From the statistical point of view, there was no significant difference in the results between the two groups. The infiltration of inflammatory cells was less than that in NS group, the proliferation of fusiform endothelial cells was obvious, and the microvessel formation was increased. On the 7th day of wound making, granulation tissue and many kinds of cells proliferated and arterioles were formed. On the 10th day, the arterioles proliferated in large numbers. Hair follicles appeared and thickened epidermal cell layer almost covered the wound. Compared with group L and group S, granulation tissue proliferation was more definite and epidermal cells crawled earlier in group L S than in group L and group S, and the proliferation of granulation tissue was more clear in group L than in group L and group S. The time required for wound healing was relatively short. GM-CSF was used to detect the GM-CSF content of mice in the group of 10% NS. The content of GM-CSF reached its peak on the 3rd day of wound manufacture, and the content of GM-CSF decreased slightly on the 7th day as compared with the third day, but maintained a higher level. On the 10th day, the GM-CSF content of L group and L S group was significantly decreased compared with the results of NS group, and the trend of the numerical change was consistent with that of NS group. The values of GM-CSF content on the 3rd day of 7 ~ (th) day of manufacturing wound showed an increasing result. The numerical results of group P0.05N S and group NS were compared with those of group L and group L, respectively, showing that the results were basically the same as those of group L, and the comparison of the results between any two groups showed that there was no significant difference between the two groups. From a statistical point of view, There was no significant difference in the results of GM-CSF content between the two groups. (P0.05DU. 4) the healing time of wound in group 1: L was shorter than that in group NS (2.000 卤0.000 d). The healing time of wound in group S was 1.875 卤0.330 d ~ (-1) shorter than that in group L and group S (2.125 卤0.330 d) and 2.250 卤0.415 d (P0.05), respectively. Conclusion: the healing time of group S is 2.125 卤0.330min / d, and that of group S is 2.250 卤0.415d (P < 0.05). Conclusion: the time of wound healing in group S is 1.875 卤0.330 days after treatment. 0.5% ropivacaine and intraperitoneal injection of sufentanil 3.0 渭 g / kg could promote wound healing. The effect of combined use is better than that of single use.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R614

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