本文關(guān)鍵詞： 羅哌卡因 舒芬太尼 創(chuàng)面愈合 GM-CSF　出處：《山西醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討羅哌卡因局部浸潤和舒芬太尼腹腔注射對人為制造的小鼠創(chuàng)面進(jìn)行愈合及其在整個(gè)愈合過程中對小鼠粒-巨噬細(xì)胞集落刺激因子(GM-CSF)的影響。方法:取健康的并且是清潔等級的雄性非雌性的SD小鼠128只,體重均在20-25g范圍之間,應(yīng)用統(tǒng)計(jì)學(xué)中規(guī)定的隨機(jī)數(shù)字表法,將128只小鼠進(jìn)行隨機(jī)分組,結(jié)果分為4組(每組數(shù)量n=32):空白生理鹽水組(NS組),羅哌卡因組(L組),舒芬太尼組(S組),羅哌卡因+舒芬太尼組(L+S組)。將小鼠稱重,用0.6%戊巴比妥鈉的藥品在小鼠的腹部將針頭刺入小鼠肚子中進(jìn)行注射麻醉,對小鼠背部進(jìn)行脫毛工作,在常規(guī)消毒之后,在小鼠背部制作一個(gè)0.8cm×0.8cm的近似標(biāo)準(zhǔn)正方形的創(chuàng)面,用眼科剪剪開皮膚的全層,直至皮下部分的致密結(jié)締組織深筋膜部分。于制造創(chuàng)面前的10min,L和L+S組皮下浸潤0.5%的局麻藥羅哌卡因,劑量為1.0ml/kg,S和L+S組在小鼠腹腔進(jìn)行注射阿片類鎮(zhèn)痛藥舒芬太尼,劑量為3.0μg/kg并且均稀釋到1.0ml。分別于制造創(chuàng)面的第3,7,10天,每組取出8只小鼠,處死后觀察每只小鼠創(chuàng)面的愈合率,取創(chuàng)面處組織進(jìn)行HE染色病理學(xué)檢測,ELISA法測定GM-CSF的表達(dá)情況,另外用BCA蛋白定量法檢測各個(gè)標(biāo)本中總蛋白的含量,用相應(yīng)的ELISA值與BCA值之比表示GM-CSF含量,將其值進(jìn)行組間比較,對每組剩余的8只小鼠進(jìn)行觀察,并且記錄其完全愈合時(shí)間。結(jié)果:(1)創(chuàng)面愈合率結(jié)果:L組、S組和L+S組小鼠的創(chuàng)面愈合率分別于制造創(chuàng)面的第3、7、10天明顯高于NS組結(jié)果,并且L+S組的結(jié)果高于L組和S組(P0.05),L組和S組的結(jié)果進(jìn)行比較,從統(tǒng)計(jì)學(xué)角度分析,兩組間結(jié)果的差別沒有明顯的意義(P0.05)。(2)病理學(xué)觀察:L組和S組小鼠制造創(chuàng)面第3天,炎癥細(xì)胞浸潤比NS組少,梭狀內(nèi)皮細(xì)胞增殖明顯,微血管生成增多。制造創(chuàng)面第7天,肉芽組織及多種細(xì)胞增殖旺盛,有小動(dòng)脈形成。制造創(chuàng)面第10天,小動(dòng)脈大量增生,毛囊出現(xiàn),增厚的表皮細(xì)胞層幾乎覆蓋創(chuàng)面。與L組和S組比較,L+S組創(chuàng)面中包含的肉芽組織增生更加明確,表皮細(xì)胞爬行更早出現(xiàn),創(chuàng)面愈合所需的時(shí)間相對縮短。(3)GM-CSF檢測:NS組小鼠制造創(chuàng)面第3天,GM-CSF含量達(dá)到高峰,第7天較第3天稍下降但仍維持較高水平,第10天明顯降低;L組和L+S組的GM-CSF含量與NS組結(jié)果進(jìn)行對比,其數(shù)值變化的趨勢表現(xiàn)出一致性,制造創(chuàng)面的第3,7,10天的GM-CSF含量的數(shù)值都呈現(xiàn)出升高的結(jié)果(P0.05);S組數(shù)值結(jié)果與NS組對比,L+S組數(shù)值結(jié)果與L組對比,分別表現(xiàn)出結(jié)果的變化走形基本一致,任意兩組間結(jié)果的比較,從統(tǒng)計(jì)學(xué)角度分析,兩組間GM-CSF含量的結(jié)果之間的差別沒有明顯的意義(P0.05)。(4)愈合時(shí)間:L組創(chuàng)面愈合時(shí)間比NS組縮短(2.000±0.000)d,S組創(chuàng)面愈合時(shí)間比NS組縮短(1.875±0.330)d,L+S組比L組和S組分別縮短(2.125±0.330)d,(2.250±0.415)d(P0.05)。結(jié)論:局部浸潤0.5%羅哌卡因和腹腔注射舒芬太尼3.0μg/kg均可促進(jìn)創(chuàng)面愈合,聯(lián)合用藥效果優(yōu)于單獨(dú)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 鹵0.000 d). The healing time of wound in group S was 1.875 鹵0.330 d ~ (-1) shorter than that in group L and group S (2.125 鹵0.330 d) and 2.250 鹵0.415 d (P0.05), respectively. Conclusion: the healing time of group S is 2.125 鹵0.330min / d, and that of group S is 2.250 鹵0.415d (P < 0.05). Conclusion: the time of wound healing in group S is 1.875 鹵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.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 李曉光;方勇;姚敏;胡孝輝;徐鵬;俞為榮;倪濤;;單核巨噬細(xì)胞集落刺激因子對人皮膚成纖維細(xì)胞增殖及膠原合成的影響[J];中國美容醫(yī)學(xué);2010年08期

2 丁浩;王智珊;高其厚;陳剛;;羅哌卡因局部浸潤聯(lián)合舒芬太尼靜脈鎮(zhèn)痛用于胸科術(shù)后鎮(zhèn)痛[J];中國美容醫(yī)學(xué);2012年18期

3 凌洪鋒,陳櫻,陳倩茹;羅哌卡因在眼科局麻手術(shù)中的應(yīng)用[J];醫(yī)學(xué)理論與實(shí)踐;2001年08期

，

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