【作者】 刘凤桐；

【导师】 尚伟；

【作者基本信息】 青岛大学 ， 口腔临床医学， 2010， 硕士

【摘要】 目的本课题根据毛细淋巴管与毛细血管内皮细胞之间链接的差别,自行研制了新型特异性染料SW,初步探讨其作为头颈部淋巴走行示踪剂的可行性及其应用价值,为进一步了解头颈部恶性肿瘤的转移规律提供新的方法。方法30只健康的新西兰大白兔随机分成三组,每组10只,前两组分别行舌背近舌缘粘膜下注射1.0%(0.14mOsm/L)的SW和1.0%(32.6mOsm/L)的甲苯胺蓝(toluidine blue TB),观察颈部淋巴管及淋巴结的染色时间和褪色时间,并测量各染料在舌体扩散的范围。淋巴结于染料着色后10min、1h和4周各摘取标本行病理组织学检查,实验动物在实验前及实验后4周处死前采血常规及生化检查,处死后取心、肺、肝、肾行病理学检查。第三组均暂时阻断双侧颈内动脉,用留置针行颈总动脉分别注射SW和TB,观察舌体组织及双侧颈部淋巴结染色情况,并于着色后各切取舌体、淋巴结、肌肉组织、颌下腺行病理组织学检查。结果SW注射后平均21.67s到达前哨淋巴结(sentinel lymph node,SLN)并使淋巴管染色,而TB平均为3.22s(P=0.000),差异有统计学意义。淋巴管从染色到明显褪色的时间：SW平均为19.7min；TB平均为14.3min(p=0.000),差异有统计学意义。SW染色的SLN4周后仍明显染色,而TB2d后已完全褪色。SW在舌体扩散的范围平均为10.5mm,而TB平均为20.0mm(p=0.000),差异有统计学意义。血液检查各项指标及主要脏器病理学检查均未见异常。第三组组织病理学检查发现舌体中SW只存在于血管中,而TB在组织间隙、血管和淋巴管中都存在,并且淋巴结、肌肉组织、颌下腺均深染。结论新染料SW在使淋巴管及淋巴结的染色上较TB有明显的延长,可以提供比较充足的手术观察时间。其在注射到组织后较固定,减少了对手术的干扰。SW溶液对淋巴管具有特异性,是一种良好的具有潜在临床价值的示踪剂。根据SW的分子结构,为我们以后影像学试剂的研制提供了良好的理论依据。更多还原

【Abstract】 ObjectiveAccording to the differences of linking between lymphatic capillaries and capillaries, we self developed a new specific dye(SW), to study head and neck lymphatic pathway by using it as the dye and its feasibility and clinical value.MethodsThirty health new zealand white rabbits were randomly divided into three groups with 10 animals in each group. To respectively injecting the SW (1.0% 0.14mOsm/L) and toluidine blue (TB)(1.0%、32.6mOsm/L) in dorsum submucosal of tongue near margin at first two groups. The dyeing time and the fading time of the lymphatics and lymph nodes were observed, and the diffusion ranges of dyes were measured in lingual. The pathological and histological examination of lymph nodes were conducted 10minutes,1 hour and 4 weeks after the lymph nodes were dyed by dyes. Routine and biochemical blood test were examined for the blood samples taken before and 4 weeks after the experiment. The rabbit s’heart s, lungs, livers and kidneys were taken 4 weeks after the experiment to perform pathologic examination. To blocking bilateral internal carotid artery in the third group, and respectively injecting SW and TB in common carotid artery with indwelling needle. The dying conditions of lingual tissue and bilateral cervical lymph node were observed. The pathological and histological examination of tongue、lymph node、muscle and submandibular gland were conducted after its were dyed by dyes.ResultsIt need average 21.67s after injected SW which arrived at sentinel lymph node and made lymphatic dye, but TB need 3.22s. There was obvious difference between them. The average fading time of the lymphatic dyed by SW was 19.7 minutes, but TB was 14.3 minutes. There was obvious difference between them. The SLN dyed by SW were still dyed deeply 4 weeks after the experiment, while which dyed by TB were faded 2 days after the experiment. The average range of SW diffused was 10.5mm in the lingual, and 20.0mm of TB. There was obvious difference between them. The routine and biochemical blood test, pathologic examination were normal. The SW was only existed in the capillaries of third group tongue after pathologic examination, but the TB were existed in the tissue space、capillaries、lymphatic capillaries, and lymph node、muscle and submandibular gland were dyed deeply.ConclusionCompared with TB, there is obvious extended of lymphatic and lymph node dyed by SW. It can provide more time for operation. SW reduces the interference of operation, because of fixed after injected tissue. SW has specific for lymphatic. The dye has latency clinical value and is a good tracer. According to molecular structure of SW, it provides a good theoretical basis for further medical imaging reagent.更多还原