应用迈之灵减轻疝无张力术后炎性反应的研究

发布时间：2018-05-05 04:02

  本文选题：疝无张力修补术 + 迈之灵　； 参考：《安徽医科大学》2015年硕士论文

【摘要】：目的以家兔为实验对象,建立腹壁疝动物实验模型,通过分组对照实验的方法,观察疝无张力修补术后植入补片的炎性反应,并观察迈之灵对于疝无张力术后炎性反应的作用。方法随机选择清洁级家兔18只,来源于安徽医科大学动物实验室,建立腹壁疝动物实验模型,随机分为3组,每组6只,空白组为单纯缝合修补,对照组放置聚丙烯补片修补,实验组放置聚丙烯补片修补后口服迈之灵,术前2 d开始给药,每天100 mg/kg;于术前、术后1、4、7、20 d于兔耳缘静脉采血,离心取血清,利用放射免疫法检测3组术前及术后不同时点血清中肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-1β的的水平,通过方差分析进行组内比较,再以q检验法组间比较;术后20 d注射空气针处死兔,观察切口局部组织水肿情况,并予评分,组织肿胀程度评分采用枳相关检验;处死兔后取补片粘连周围组织,浸于10%甲醛溶液中,按常规方法行标本HE染色,光镜下观察组织病理学改变。结果术后对照组有1例发生感染,3组间均无死亡情况发生。实验组(6只)切口皮肤肿胀评分为3分,对照组(6只)为13分,2组间差异有统计学意义(P0.05);术前空白组、对照组、实验组家兔血清的TNF-α和IL-1β的表达差异无统计学意义[TNF-α分别为(1.35±0.14)、(1.19±0.12)、(1.11±0.32)μg/L和IL-1β分别为(0.052±0.011)、(0.053±0.022)、(0.073±0.024)μg/L,P0.05)];术后4 d、7d,对照组TNF-α和IL-1β表达明显高于空白组、实验组,差异均有统计学意义[对照组TNF-α为(3.40±0.59)μg/L和(5.5±0.8)μg/L,IL-1β为(0.35±0.161)μg/L和(0.655±0.132)μg/L,空白组TNF-α为(1.48±0.29)μg/L和(1.6±0.4)μg/L,IL-1β为(0.113±0.015)μg/L和(0.120±0.015)μg/L,实验组TNF-α为(2.07±0.53)μg/L和(2.4±0.6)μg/L,IL-1β为(0.237±0.079)μg/L和(0.237±0.079)μg/L,均P0.05],相对于空白组,实验组和对照组的炎性细胞因子表达均有明显上升,术后1周时差异最大,但实验组较对照组升高明显减轻,表明在服用迈之灵后,仍存在一定的炎性反应,但较不服用轻,迈之灵可一定程度上减轻植入材料所引起的炎性反应。结论服用迈之灵后手术切口区域肿胀情况明显减轻,可有效降低术后细胞因子的表达,从而减轻全身细胞免疫反应。提示迈之灵可应用于临床,有效减轻疝无张力术后炎性反应所引起的术后并发症。
[Abstract]:Objective to establish an animal model of abdominal wall hernia in rabbits and to observe the inflammatory response of patch implantation after tension-free hernioplasty and to observe the effect of Myelin on the inflammatory response after tension-free hernia repair. Methods Eighteen rabbits of clean grade were randomly selected from animal laboratory of Anhui Medical University to establish the animal model of abdominal wall hernia. They were randomly divided into 3 groups with 6 rabbits in each group. The blank group was treated with simple suture repair and the control group with polypropylene patch repair. The experimental group was treated with methylpropene patch and orally administered with Mizuling 2 days before operation, 100 mg / kg per day, and blood samples were collected from the rabbit auricular vein for 20 days before operation, and the serum was collected by centrifugation, and the blood samples were collected from the rabbit ear margin vein for 20 days after the operation. The levels of TNF- 伪 TNF- 伪 and IL-1- 尾 in serum of three groups were detected by radioimmunoassay before and after operation. The results were compared by ANOVA and Q test. 20 days after operation, the rabbits were killed by air needle injection, the local tissue edema was observed, and the degree of tissue swelling was evaluated by trifoliate orange correlation test, after the rabbits were killed, the tissue around the patch adhesion was taken and immersed in 10% formaldehyde solution. Specimens were stained with HE and histopathological changes were observed under light microscope. Results there was no death in one patient in the control group after operation. The score of skin swelling in the experimental group was 3, and that in the control group was 13. There was significant difference between the two groups (P 0.05). There was no significant difference in the expression of TNF- 伪 and IL-1 尾 in serum of the experimental group (1.35 卤0.14) 渭 g / L (1.19 卤0.12) 渭 g / L and IL-1 尾 were 0.052 卤0.011 卤0.053 卤0.053 卤0.022 卤0.073 卤0.024 渭 g / L respectively in the control group, and the expression of TNF- 伪 and IL-1 尾 in the control group was significantly higher than that in the control group at 4 days after operation. In the experimental group, the expression of TNF- 伪 and IL-1 尾 in the control group was significantly higher than that in the control group. In the experimental group, the expression of TNF- 伪 and IL-1 尾 in the control group was significantly higher than that in the control group. 宸�寮傚潎鏈夌粺璁″�︽剰涔塠瀵圭収缁凾NF-伪涓，

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