Effect Of Radix Salviae Miltiorrhizae On Fibrin Sheath In Venous Indwelling Catheter

Objective:To establish the fibrin sheath model related to venous indwelling catheter,to detect the internal components of fibrin sheath in different indwelling phase,and to clarify its dynamic process to explore the mechanism of fibrin sheath formation and the intervention effect of Salvia miltiorrhiza.Methods:1.152 rabbits were randomly divided into pre test group(32),positive control group(40),experimental group(40),and experimental control group(40rats).The pretest group was randomly divided into four groups: 6h,12 h,1D group and blank control group.The positive control group,the experimental group and the experimental control group were randomly divided into five indwelling phase groups(indwelling 12 h,1D,2D,3D,4D group).2.The pre experimental group and the positive control group were intravenous mannitol;the experimental group was intravenous mannitol and Injection Salvia miltiorrhiza injection;the experimental control group was intravenous mannitol,and low molecular weight heparin calcium was injectedsubcutaneously.3.The pretest group observed the sheath like structure of fibrin sheath and the detection of the concentration of D-two polymer by HE staining to determine the initial phase of fibrin sheath formation.The clinical clues of fibrin sheath formation were recorded in the positive control group,the experimental group and the experimental control group-the time required for the drop of the unit liquid and the characteristics of the mechanism.Valve phenomenon,HE staining was used to observe the morphological structure of fibrin sheath,Masson staining was used to detect collagen fiber,Mallory staining was used to detect fibrin and immunohistochemistry was used to detect endothelial cells and smooth muscle cells,so as to clarify the dynamic process and mechanism of its formation.Results:1.Catheter indwelling 12 h,the fibrin sheath began to form.2.The time,the frequency of fibrin sheath mechanical valve,the ratio of fibrin sheath area to the lumen area of the auricular vein,the longer the retention time was,the higher the value was,the difference was statistically significant(P< 0.01).There was no endothelial cells and smooth muscle when 12 h and 1D were left.The positive expression of cells was positive,and the positive expression of endothelial and smooth muscle cells was found in 2D,and the longer the retention time was,the more the expression was,the difference was statistically significant(P < 0.05).3.The internal components of fibrin sheath in 12 h and 1D contained only fibrin,red blood cells and platelets,and fibroblasts,endothelial cells and smooth muscle cells were added to 2D,and collagen fibers and elastic fibers were added to 3D and 4D.4.The time,the frequency of fibrin sheath mechanical valve,the ratio of fibrin sheath area to the lumen area of the auricular vein,the ratio of the positive expression area of the endothelial cells and the smooth muscle cells were significantly lower than those in the positive control group,and the difference was all lower than that of the positive control group.Statistical significance(P <0.01);the time required for the infusion of drugs in the experimental group,the frequency of fibrin sheath mechanical valve,the ratio of fibrin sheath area to the lumen area of the auricular vein and the area ratio of the endothelial cell positive expression area to the fibrin sheath area were similar to those of the experimental group,and the difference was not statistically significant.(P >0.05),but the area ratio of the positive expression of smooth muscle cells in the experimental group was significantly lower than that in the experimental group,and the difference was statistically significant(P < 0.01).5.In the experimental group,the experimental control group and the positive control group,the changes in the internal components of the fibrin sheath were the same,but the fibrin sheath area of the experimental group and the experimental control group was significantly lower than that of the positive control group,and the appearance of the collagen fiber was later than that in the positive control group.Conclusions:1.The formation of fibrin sheath is a dynamic process,and the components of different indwelling phase are different,mainly including fibrin,red blood cells,platelets,fibroblasts,endothelial cells,smooth muscle cells,collagen fibers and elastic fibers.2.The effect of Salvia miltiorrhiza and low molecular weight heparin calcium on fibrin sheath is similar,but Salvia miltiorrhiza has an inhibitoryeffect on smooth muscle cells in fibrin sheath,and has some advantages in inhibiting or postponing the growth and extension of fibrin sheath.