發(fā)布時(shí)間：2018-04-26 16:59

  本文選題：留置針 + 靜脈炎��； 參考：《錦州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的本課題應(yīng)用靜脈留置針?biāo)聶C(jī)械性靜脈炎動(dòng)物模型,觀察芒硝外敷對(duì)靜脈炎血管損傷及靜脈血管組織中白介素-1(IL-1)、白介素-6(IL-6)、腫瘤壞死因子-α(TNF-α)表達(dá)的干預(yù)作用,探討芒硝外敷對(duì)靜脈留置針?biāo)聶C(jī)械性靜脈炎的預(yù)防作用,為預(yù)防靜脈留置針?biāo)鸬臋C(jī)械性靜脈炎提供實(shí)驗(yàn)數(shù)據(jù)。方法選取同種健康大耳新西蘭兔57只,隨機(jī)分為3組,分別為空白對(duì)照組(9只)、留置針組(24只)、芒硝外敷組(24只),留置針組和芒硝外敷組每只兔子的耳緣靜脈進(jìn)行靜脈留置針穿刺。留置針組,每日一次進(jìn)行靜脈注射0.9%氯化鈉注射液20ml;芒硝外敷組是在留置針組的基礎(chǔ)上給予芒硝固定外敷。在留置的第3d,5d,7d時(shí),空白對(duì)照組隨機(jī)抽取3只,取耳緣靜脈標(biāo)本;留置針組和芒硝外敷組,分別隨機(jī)抽取8只,拔除靜脈留置針,取耳緣靜脈標(biāo)本,所有靜脈標(biāo)本做病理組織切片。光鏡觀察每組兔耳緣靜脈HE染色病理組織切片,用免疫熒光法檢測(cè)每組兔耳緣靜脈血管組織中IL-1、IL-6、TNF-α的表達(dá)情況。結(jié)果HE染色結(jié)果:空白對(duì)照組無(wú)炎性細(xì)胞浸潤(rùn),血管壁周?chē)鸁o(wú)纖維組織增生。隨著留置時(shí)間的增加,留置針組及芒硝外敷組兔耳緣靜脈均有血管壁纖維組織增生、血管組織中炎性細(xì)胞浸潤(rùn)增加、機(jī)化血栓增多。將芒硝外敷組與留置針組比較,血管壁中纖維組織明顯降低,炎性細(xì)胞浸潤(rùn)顯著減少。免疫熒光檢測(cè)結(jié)果:在同一留置時(shí)間,留置針組和芒硝外敷組IL-1、IL-6、TNF-α表達(dá)均明顯高于空白對(duì)照組(P0.05);芒硝外敷組IL-1、IL-6、TNF-α表達(dá)均低于留置針組(P0.05);留置針組和芒硝外敷組同組中不同時(shí)間比較,IL-1、IL-6、TNF-α的表達(dá)與留置時(shí)間呈正相關(guān)。結(jié)論芒硝外敷能明顯減少兔耳緣靜脈炎癥細(xì)胞浸潤(rùn)、血管壁纖維組織增生及血栓形成。芒硝外敷可顯著減少靜脈留置針?biāo)聶C(jī)械性靜脈炎組織中IL-1、IL-6及TNF-α的表達(dá),降低兔耳緣靜脈的炎癥反應(yīng)。
[Abstract]:Objective to observe the effect of external application of glauberite on phlebitis vascular injury and the expression of interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-偽 (TNF- 偽) in vascular tissue of phlebitis by using the animal model of mechanical phlebitis induced by intravenous indwelling needle. To explore the preventive effect of external application of glauberite on mechanical phlebitis caused by intravenous indwelling needle, and to provide experimental data for preventing mechanical phlebitis caused by intravenous indwelling needle. Methods 57 healthy New Zealand rabbits were randomly divided into 3 groups. Nine rabbits in the blank control group, 24 rabbits in the indwelling needle group, 24 rabbits in the external application group of mirabilite, and each rabbit in the indwelling needle group and the external application group were punctured with vein indwelling needle. In the indwelling needle group, 0.9% sodium chloride injection 20ml was injected intravenously once a day, and the external application group was fixed on the basis of the indwelling needle group. At the 3rd day of indwelling for 5 days and 7 days after indwelling, 3 cases were randomly selected from the blank control group, 8 from the indwelling needle group and 8 from the external application group, respectively, the venous indwelling needle was extracted, and the auricular vein sample was taken from the auricular vein specimen. All the venous specimens were made by pathological sections. The pathological sections of rabbit auricular vein stained with HE were observed under light microscope, and the expression of IL-1 and IL-6 TNF- 偽 in vein tissue of each group was detected by immunofluorescence. Results HE staining showed that no inflammatory cells were infiltrated and no fibrous tissue proliferated around the vascular wall in the blank control group. With the increase of indwelling time, vascular wall fibrous tissue proliferation, inflammatory cell infiltration and organized thrombus increased in both the indwelling needle group and the external application group. Compared with the indwelling group, the fibrous tissue and inflammatory cell infiltration in the vascular wall were significantly decreased in the application group. Immunofluorescence results: at the same retention time, The expression of IL-1TNF- 偽 in the indwelling group and the external application group was significantly higher than that in the blank control group (P0.05A), and the expression of IL-1mil IL-6TNF- 偽 was lower than that in the indwelling needle group (P0.05A), and the expression of IL-1IL-6TNF- 偽 was positively correlated with the indwelling time in the indwelling needle group and the oral application group (P < 0.05). Conclusion Glauber's application can significantly reduce inflammatory cell infiltration, vascular wall fibrous tissue proliferation and thrombus formation in rabbit auricular vein. The expression of IL-1- 6 and TNF- 偽 in mechanical phlebitis tissue induced by intravenous indwelling needle was significantly reduced by external application of glauberite, and the inflammatory response of rabbit auricular vein was decreased.
【學(xué)位授予單位】：錦州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R472

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