不同时期治疗缺血性肌挛缩的实验研究  

EMPIRIACL STUDY OF THERAPEUTICS ON ISCHEVMIC CONTRACTURE EM DIFFERENT PERIODS

作　　者：苏庆军[1] 陈德松[2] 方有生[2] 曲铁兵[1] 王志为[1] 海涌[1] 

机构地区：[1]首都医科大学附属朝阳医院,北京100020 [2]复旦大学附属华山医院

出　　处：《中医正骨》2008年第11期15-16,共2页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:探讨大鼠肢体缺血性肌挛缩不同时期治疗的疗效差异。方法:建立大鼠肢体缺血性肌挛缩的模型。分别在即刻、8小时、24小时、3天、1周、2周和4周进行筋膜切开减压,松解神经、肌肉,恢复各自结构的独立性,术后第8周测定腓深神经的潜伏期和诱发肌电位的波幅,腓深神经和胫前肌作组织学检查,测量腓深神经横断面单位面积内有髓轴突截面积之和。结果:腓深神经潜伏期随手术延迟而延长,诱发肌电位的波幅随手术延迟而降低,有髓轴突截面积随手术延迟而减少。组织学检查肌纤维排列紊乱,肌纤维变性和纤维化,手术愈早,上述变化愈轻;手术愈早,有髓纤维排列愈紧密,着色重,愈接近正常。结论:急性期和/或早期减压松解治疗大鼠肢体缺血性肌挛缩是必要和有效的,手术越早,疗效越好。为临床早期减压松解治疗缺血性肌挛缩提供了可靠的实验室依据。Objective:To approach the discrepancy of curative effect on ischemic contracture of rats' limbs in different periods.Methods:Rat models with ischemic contracture in limbs were built,and were respectively carried out for open decompression of anadesma on times of instant,8 hours,24 hours,3 days,1 week,2 weeks and 4 weeks.Nerves and muscles were relaxed,formative independence of them were obtained again.8 weeks post-operation the eclipse period of fibular deep nerve and wave amplitude of induced myopotential were determined,fibular deep nerve and tibial anterior muscle were carried out for examination on histological anatomy,the total numbers of myelinated axon section area in unit area of fibular deep nerve's transection were surveyed.Result:With the operation postponed,eclipse period of fibular deep nerve extended,wave amplitude of induced myopotential degraded,the total numbers of myelinated axon section area reduced.On histological anatomy,confused align ment,myofibrosis and fibrous degeneration could be seen on muscle fiber.With operation was done earlier,Changes eased much,alignment of myelinated fibre was tighter,coloration was thicker,and the framework was much close to the normal.Conclusion:It was necessity and effective to reduce pressure and treat for ischemic contracture of rats' limbs in acute stag and/or earlier period.The effect was better as operation was done earlier.From this it could supply dependable lab base for curing ischemic contracture with decompression and solution in earlier period clinically.

关 键 词：缺血性肌挛缩/治疗 治疗时机 实验研究 动物 大鼠 

分 类 号：R685[医药卫生—骨科学] R746.4[医药卫生—外科学]