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| 題 名 | The Influence of Intra-Graft Heparin Injection on the Survival of Composite Grafts=移植片內肝素注射對複合移植片存活率的影響 |
|---|---|
| 作 者 | 陳伊呈; 顏榮信; 歐令奮; 唐友文; 姜明珠; | 書刊名 | 中華醫學雜誌 |
| 卷 期 | 61:6 1998.06[民87.06] |
| 頁 次 | 頁346-352 |
| 分類號 | 416.41 |
| 關鍵詞 | 複合移植片; 肝素; 移植片內注射; Composite graft; Heparin; Intra-graft injection; |
| 語 文 | 英文(English) |
| 中文摘要 | 背景:在重植組織內皮下注射肝素,造成持續出血以代替靜脈吻合術,曾被引用於遠端手指的重 接術中,以挽救困難的重植病例。此法亦被建議使用於以複合皮片形式植回之遠端手指截肢重植。為測定 複合皮片注射肝素使皮片經由手術切口持續滲血之方式,是否能增加較大複合移植皮片之存活率,我們以 兔耳複合片為實驗模式,研究三種不同劑量及注射間隔之移植片內肝素注射所造成的影響。 方法:本實驗以10、15、20、25毫米之兔耳複合片(含耳背皮膚及軟骨)為對照組,其中以取自對側耳直徑25 毫米之兔耳複合移植片呈現最低的皮片存活百分率(平均存活17.0±5.6%,p<0.05)故被選為研究組之模 式,其結果作為研究組對照數據。我們以三種不同劑量及不同注射間隔在移植片內進行肝素注射,觀察複 合移植片之存活比率。 結果:實驗組中以250 IU/0.1 ml肝素每日注射於移植片內,連續注射七日,所得之皮片存活百分率明顯 較其它注射方式以及對照組為高(平均存活64.0□9.7%,p<0.05)。皮片植入後的顏色變化及經移植片內注 射肝素造成持續滲血的現象,可於實驗過程中被觀察到。 結論:移植片內肝素注射於直徑25毫米之兔耳複合移植片中,造成較高的平均存活百分率,但造成皮片存 活率增加的機轉無法在本實驗中詳細證實。我們建議臨床上欲使用皮片內肝素注射以試圖增加存活率時, 必須避免複合皮下血腫聚積,同時病人的整體出血傾向也必須密切監測。 |
| 英文摘要 | Background: Intra-replant subcutaneous heparin injection has been reported to be an alternative to venous anastomoses in finger replantations. It has also been recommended for composite graft type replants. In this study, we investigated three different regimens of intra-graft heparin injection in a rabbit ear model. Our aim was to determine whether or not continuous oozing from an incision wound on a composite graft made by an intragraft heparin injection would increase the survival of a larger composite graft. Methods: A 25-mm-diameter circular composite graft (including dorsal skin and auricular cartilage) was harvested from the mid-portion of a rabbit ear. This size of graft was selected as the study model due to a significantly lower percent graft survival when compared to smaller-sized grafts (17.0±5.6%, p <0.05). Three different regimens of intra-graft heparin injection were performed in the study group and the results of percent graft survival were compared. Results: Intra-graft injection of heparin calcium 250 IU/0.l ml qd for seven days resulted in a significantly higher percent graft survival than the other two regimens and a control group )64.0±9.7%, p<0.05). The "flow-through" phenomenon was observed in this study. Conclusions: Intra-graft heparin injection resulted in a higher percent graft survival than the control group for the 25-mm-diameter circular composite graft. However, the mechanism of graft survival enhancement could not be clearly explained by this study. It is recommended that the clinical application of intra-graft heparin injection should only be used when subgraft hematoma can be avoided and systemic bleeding tendency is being closely monitored. |
本系統中英文摘要資訊取自各篇刊載內容。