本文選題：疝無張力修補(bǔ)術(shù) + 邁之靈��； 參考：《安徽醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的以家兔為實(shí)驗(yàn)對象,建立腹壁疝動(dòng)物實(shí)驗(yàn)?zāi)Ｐ?通過分組對照實(shí)驗(yàn)的方法,觀察疝無張力修補(bǔ)術(shù)后植入補(bǔ)片的炎性反應(yīng),并觀察邁之靈對于疝無張力術(shù)后炎性反應(yīng)的作用。方法隨機(jī)選擇清潔級家兔18只,來源于安徽醫(yī)科大學(xué)動(dòng)物實(shí)驗(yàn)室,建立腹壁疝動(dòng)物實(shí)驗(yàn)?zāi)Ｐ?隨機(jī)分為3組,每組6只,空白組為單純縫合修補(bǔ),對照組放置聚丙烯補(bǔ)片修補(bǔ),實(shí)驗(yàn)組放置聚丙烯補(bǔ)片修補(bǔ)后口服邁之靈,術(shù)前2 d開始給藥,每天100 mg/kg;于術(shù)前、術(shù)后1、4、7、20 d于兔耳緣靜脈采血,離心取血清,利用放射免疫法檢測3組術(shù)前及術(shù)后不同時(shí)點(diǎn)血清中腫瘤壞死因子α(TNF-α)、白細(xì)胞介素(IL)-1β的的水平,通過方差分析進(jìn)行組內(nèi)比較,再以q檢驗(yàn)法組間比較;術(shù)后20 d注射空氣針處死兔,觀察切口局部組織水腫情況,并予評分,組織腫脹程度評分采用枳相關(guān)檢驗(yàn);處死兔后取補(bǔ)片粘連周圍組織,浸于10%甲醛溶液中,按常規(guī)方法行標(biāo)本HE染色,光鏡下觀察組織病理學(xué)改變。結(jié)果術(shù)后對照組有1例發(fā)生感染,3組間均無死亡情況發(fā)生。實(shí)驗(yàn)組(6只)切口皮膚腫脹評分為3分,對照組(6只)為13分,2組間差異有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)前空白組、對照組、實(shí)驗(yàn)組家兔血清的TNF-α和IL-1β的表達(dá)差異無統(tǒng)計(jì)學(xué)意義[TNF-α分別為(1.35±0.14)、(1.19±0.12)、(1.11±0.32)μg/L和IL-1β分別為(0.052±0.011)、(0.053±0.022)、(0.073±0.024)μg/L,P0.05)];術(shù)后4 d、7d,對照組TNF-α和IL-1β表達(dá)明顯高于空白組、實(shí)驗(yàn)組,差異均有統(tǒng)計(jì)學(xué)意義[對照組TNF-α為(3.40±0.59)μg/L和(5.5±0.8)μg/L,IL-1β為(0.35±0.161)μg/L和(0.655±0.132)μg/L,空白組TNF-α為(1.48±0.29)μg/L和(1.6±0.4)μg/L,IL-1β為(0.113±0.015)μg/L和(0.120±0.015)μg/L,實(shí)驗(yàn)組TNF-α為(2.07±0.53)μg/L和(2.4±0.6)μg/L,IL-1β為(0.237±0.079)μg/L和(0.237±0.079)μg/L,均P0.05],相對于空白組,實(shí)驗(yàn)組和對照組的炎性細(xì)胞因子表達(dá)均有明顯上升,術(shù)后1周時(shí)差異最大,但實(shí)驗(yàn)組較對照組升高明顯減輕,表明在服用邁之靈后,仍存在一定的炎性反應(yīng),但較不服用輕,邁之靈可一定程度上減輕植入材料所引起的炎性反應(yīng)。結(jié)論服用邁之靈后手術(shù)切口區(qū)域腫脹情況明顯減輕,可有效降低術(shù)后細(xì)胞因子的表達(dá),從而減輕全身細(xì)胞免疫反應(yīng)。提示邁之靈可應(yīng)用于臨床,有效減輕疝無張力術(shù)后炎性反應(yīng)所引起的術(shù)后并發(fā)癥。
[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- 偽 TNF- 偽 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- 偽 and IL-1 尾 in serum of the experimental group (1.35 鹵0.14) 渭 g / L (1.19 鹵0.12) 渭 g / L and IL-1 尾 were 0.052 鹵0.011 鹵0.053 鹵0.053 鹵0.022 鹵0.073 鹵0.024 渭 g / L respectively in the control group, and the expression of TNF- 偽 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- 偽 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- 偽 and IL-1 尾 in the control group was significantly higher than that in the control group. 宸紓鍧囨湁緇熻瀛︽剰涔塠瀵圭収緇凾NF-偽涓，

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