高压电烧伤家兔球结膜微循环变化和己酮可可碱干预作用  

Alteration in bulbar conjunctiva microcirculation and interventional effect of Pentoxifylline after high-voltage electrical burn in rabbits

作　　者：张庆富[1] 闫宝勇[1] 周慧敏[1] 王车江[1] 

机构地区：[1]河北医科大学第一医院烧伤整形外科,石家庄050031

出　　处：《中华烧伤杂志》2010年第3期185-191,共7页Chinese Journal of Burns

基　　金：河北省自然科学基金（302551）

摘　　要：目的 了解高压电烧伤家兔球结膜微循环（BCM）的变化,以及己酮可可碱（PTX）对BCM障碍的疗效.方法 将45只家兔按随机数字表法分为对照组、电伤组和治疗组,每组15只.电伤组和治疗组家兔均用调压器及实验变压器制成高压电烧伤模型,治疗组随即给予PTX注射;对照组家兔接相同装置但不通电,致假伤.用微循环显微镜观测3组家兔伤前15 min及伤后5 min、1h、2 h、4 h、8 h BCM变化,包括：（1）微血管形态,如清晰度,微动、静脉及毛细血管直径,是否存在粗细不均现象及缺血区.（2）微血流动态,如微动、静脉及毛细血管血流速度,红细胞聚集和微血栓形成情况.（3）微血管周围状态,如出血、渗出情况.计量资料行t检验,计数资料采用确切概率法检验.结果 （1）微血管形态：电伤组和治疗组家兔伤后微血管清晰度较伤前下降,但治疗组好于电伤组.伤后5 min,电伤组微动、静脉和毛细血管直径分别为（7.3±2.5）、（12.3±2.4）、（3.5±0.7）μm,均小于对照组的（14.6±3.1）、（27.2±3.5）、（9.0±1.4）μm（t值分别为5.23、13.66、14.04,P值均小于0.05）;治疗组分别为（10.2±3.8）、（21.5±3.1）、（7.1±1.2）μm,均大于电伤组（t值分别为2.21、8.99、10.18,P值均小于0.05）.伤后1 h,电伤组和治疗组微动脉直径均恢复至伤前水平.伤后2-8 h,电伤组微动脉和毛细血管直径逐渐减小,微静脉直径逐渐增大;治疗组上述变化不明显.电伤组伤后5 min微血管呈粗细不均状,持续至8 h;出现缺血区,2 h时好转.治疗组情况较之明显改善.（2）微血管血流动态：伤后5 min,电伤组微动、静脉及毛细血管血流速度分别为（202±53）、（198±44）、（46±12）μm/s.慢于对照组的（544±37）、（359±32）、（220±19）μm/s（t值分别为20.47、11.51、30.02.P值均小于0.05）;治疗组分别为（335±42）、（260±35）、（119±23）μm/s,快于电伤组（tObjective To study the changes in bulbar conjunctiva microcirculation （BCM） and the therapeutic effect of Pentoxifylline on BCM disturbance after high-voltage electrical burn （HEB） in rabbits. Methods Forty-five rabbits were divided into control group （C） , electrical burn group （EB） , and Pentoxifylline treatment group （PT） according to random number table, with 15 rabbits in each group. Model of HEB was reproduced in rabbits from EB and PT groups with voltage regulator and experimental transformer. Rabbits in C group were sham injured with the same devices without electrification. Changes in BCM were observed with microcirculation microscope at 15 minutes before HEB and 5 minutes, 1, 2, 4, 8 hour （s） post HEB （PHM or PHH） , including： （1） morphology of microvessels, such as the descemibleness, diameters of arterioles, venules, and capillaries, the unevenness in caliber, and ischemic area; （2） dynamic changes in microvascular blood flow, such as blood flow speed in arterioles, venules, and capillaries, erythrocyte aggregation, and microthrombi formation; （3） condition of tissues surrounding microvessel, such as bleeding and exudation. Measurement data were processed with t test; enumeration data were processed with Fisher＇s exact test. Results （1） Morphology of microvessel： descernibleness of microvessels in EB and PT groups was decreased, but that of PT group was better than that of EB group. At PHM 5 , diameter of ar-terioles, venules and capillaries was respectively （7. 3 ± 2. 5） , （12. 3 ± 2. 4） , （3. 5 ± 0. 7） μm in EB group, all narrower than those of the control group [（14.6 ±3. 1） , （27.2±3.5）, （9.0±1.4） μm, with t value respectively 5. 23 , 13. 66, 14. 04, P values all below 0. 05]. Diameters of the microvessels in PT group [（10. 2 ±3.8） , （21.5±3.1）, （7. 1 ±1.2） μm] were larger than those in EB group （with t value respectively 2. 21 , 8. 99, 10. 18, P values all below 0. 05）. Diameters of arterioles, v

关 键 词：烧伤 电 结膜 微循环 己酮可可碱 

分 类 号：R647[医药卫生—外科学]