低分子肝素对实验兔 PICC 相关性血栓抑制作用的研究
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1.金华职业技术学院,浙江 金华 321017; 2.金华市中心医院,浙江 金华 321000; 3.金华市人民医院,浙江 金华 3210002; 4.浙江省医学科学院,杭州 310013

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R-33

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Inhibitory effect of low molecular weight heparin on catheter-related thrombosis with a peripherally inserted central catheter in rabbits
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1.Jinhua Polytechnic, Jinhua 321017, China. 2. Jinhua Municipal Central Hospital, Jinhua 321000. 3. JinHua People’s Hospital, Jinhua 321000. 4. Zhejiang Academy of Medical Sciences, Hangzhou 310013

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    摘要:

    目的 探讨不同浓度低分子肝素对 PICC 相关性血栓( catheter related thrombosis, CRT)形成的抑制 作用。 方法 将 40 只实验兔按随机数字表法分为 A 组(对照组)、B 组(低浓度低分子肝素组)、C 组(中浓度低分 子肝素组)、D 组(高浓度低分子肝素组),成功建立 PICC 实验兔模型后,分别用 0. 9%氯化钠溶液、50 μ/ (mL·d)低 分子肝素钠溶液、100 μ/ (mL·d)低分子肝素钠溶液、200 μ/ (mL·d)低分子肝素钠溶液在实验兔腹部进行皮下注 射,每日 1 次连续 7 d。 截取耳缘静脉、前腔静脉以及 PICC 导管进行 HE 染色,光镜下观察并比较四组实验兔不同 部位的 CRT 发生率以及凝血功能情况。 结果 A 组 CRT 发生率为 100%,D 组无血栓发生,A 组与其它三组间血栓 发生率比较差异有统计学意义(P<0. 01)。 其中,A 组、B 组、C 组实验兔耳缘静脉血栓发生率与 D 组比较差异有统 计学意义(P<0. 01)。 A 组、B 组的 PICC 导管血栓发生率与 C 组、D 组间比较差异有统计学意义(P<0. 01)。 PICC 置管一周后,血 PT、APTT、TT、FIB、D-D 二聚体含量在各组间比较差异有统计学意义(P<0. 01)。 结论 不同浓度低分子肝素对 CRT 形成有预防作用,且随着浓度的递升作用渐增,其中高浓度低分子肝素 200 μ/ (mL·d)可有效预 防 CRT 形成并降低发生率,具有重要的临床意义。

    Abstract:

    Objective To explore the inhibitory effect of various concentrations of low molecular weight heparin on the formation of catheter-related thrombosis ( CRT). Methods Forty rabbits were divided into group A ( control group), group B (low concentration low molecular weight heparin group), group C (medium concentration low molecular weight heparin group), and group D (high concentration low molecular weight heparin group) in accordance with a random number table. After successfully establishing the PICC catheterized rabbit model, a 0. 9% sodium chloride solution, or 50 μ/ (mL·d), 100 μ/ (mL·d), or 200 μ/ (mL·d) low molecular weight heparin sodium solutions were applied. The solution was injected subcutaneously into the abdomen of the rabbits once a day for 7 consecutive days. The auricular vein,anterior vena cava, and PICC catheters of the rabbits were removed for HE staining, and the incidence of CRT and coagulation functions in different parts were observed and compared under a light microscope. Results The incidence of CRT in group A was 100% and there was no thrombosis in group D. The difference in the incidence of thrombus between group A and the other three groups was statistically significant ( P < 0. 01). The incidences of rabbit auricular vein thrombosis in groups A-C were significantly different from that of group D (P<0. 01). The incidences of PICC catheter thrombosis in groups A and B were significantly different from that in groups C and D (P<0. 01). One week after PICC insertion, blood PT, APTT, TT, FIB, and D-D dimer levels were significantly different among the groups (P< 0. 01). Conclusions Different concentrations of low molecular weight heparin have a preventive effect on the formation of CRT. A high concentration low molecular weight heparin 200 μ/ (mL·d) effectively prevents the formation of CRT and reduces its incidence, which has important clinical significance.

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黄利全,梁淑霞,陈 黎,陈桂园,胡 波,褚晓峰.低分子肝素对实验兔 PICC 相关性血栓抑制作用的研究[J].中国比较医学杂志,2020,30(10):78~84.

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  • 收稿日期:2020-04-13
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  • 在线发布日期: 2020-11-25
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