| Objective With the increase of maternal pregnancy in the scar uterus,the incidence of sinister placenta previa and placenta implantation is increasing gradually rising,leading to an increase in maternal postpartum hemorrhage and hysterectomy.In recent years,abdominal aorta has been used in this type of cesarean section.Balloon ablation,which blocks the abdominal aorta,has a good hemostatic effect,but it is difficult to investigate whether it is caused by uterine ischemia-reperfusion injury.The degree of ischemia-reperfusion injury is related to the time of ischemia.How to minimize the occurrence of complications within the effective blocking time needs to be resolved.In this study,we established ischemia and ischemia-reperfusion time in animal models to detect changes in serum levels of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6),as well as Toll-like receptor 4(TLR4)and nuclear factor-k B/p65(NF-k B/p65)expression in uterine tissue.To determine whether there is uterine ischemia-reperfusion injury.and the severity of ischemia-reperfusion injury caused by different blocking time,on the abdominal aorta The time safety of the blockade was further validated to provide a theoretical basis for the safety of clinical application of abdominal aortic occlusion.To explore the severity of ischemia-reperfusion injury caused by different blocking time,and to verify the time safety of abdominal aortic occlusion,and to provide a theoretical basis for the safety of clinical application of abdominal aortic occlusion.Methods Forty female rabbits were randomly divided into 4 groups according to the infrarenal abdominal aorta blocking time: 20 min(B),40 min(C),60 min(D)and sham operation(A).The sham operation group was not blocked,and the other 3 groups were treated with reperfusion after subthalamic aortic occlusion.The sham operation group was not blocked,and the other 3 groups were treated with reperfusion after enal lower abdominal aorta occlusion.Cervical venous blood was taken before surgery(T0),reperfusion for 10 min(T1),reperfusion for 40 min(T2),and reperfusion for 90 min(T3).Enzyme-linked immunosorbent assay(ELISA)was used to detect changes in factor-?and interleukin-6 concentrations in serum.After 90 minutes of reperfusion,the rabbits were sacrificed and the uterus tissue was taken.The changes of myometrial tissue under light microscope were observed.The immunohistochemical SP method and Western blot were used to detect the expression of Toll-like receptor 4(TLR4)and nuclear factor-kb /p65(NF-k B/p65)in uterine muscle tissue,and correlation analysis was conducted.Statistical analysis was performed using SPSS 23.0,data was used by (?)±s,and repeated measurement data between groups were analyzed by repeated measures analysis of variance.P<0.05 was considered statistically significant.Results 1.There was no difference in TNF-? and IL-6 concentrations between group A and group B at any time point(P>0.05).The concentration of IL-6 in group C at time T1 was higher than that in group A and group B,and the concentration of TNF-and IL-6 at time T2 and T3 were also higher than that in group A and group B(P < 0.05).The concentration of TNF-and IL-6 in group D was higher than that in the other three groups at time points after reperfusion(P < 0.05).2.The uterine intermuscular tissue structure of group A was normal,while prolonged the ischemic time,the inflammatory cell infiltration gradually increased,and the interstitial swelling was obvious in group B,group C,and group D.3.The expression of TLR4 and NF-k B/p65 protein in myometrium was significantly increased in B,C and D groups,and increased with the prolongation of ischemia time,especially in group C and group D(P<0.05).Conclusion 1.In this experiment,an animal model of uterine ischemia-reperfusion was established by blocking the inferior abdominal aorta of female rabbits.The results showed that after the abdominal aorta is blocked,the uterus undergoes ischemia-reperfusion injury,and with the prolongation of ischemia time,the degree of injury becomes more and more serious.2.Abdominal aorta occlusion for 20 min is a safe aging for abdominal aortic occlusion,and uterine damage is small after reperfusion.3.After 60 minutes of abdominal aorta occlusion,the inflammatory reaction of uterine tissue was obvious,and myocyte lysis occurred after reperfusion.After blocking for 40 minutes,only some inflammatory cells infiltrated in the uterus after reperfusion,and no muscle cells were dissolved,so the damage to the body was small.This result has reference value for clinical practice,and it is recommended that the time to block the abdominal aorta in clinical should not exceed 40 minutes. |
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