大鼠胫骨前肌微循环的两种压力损伤效应研究  

Two types of pressure-induced microvessel injury on rat tibialis anterior muscle

作　　者：王淮玲[1] 王维平[1] 彭佳华[1] 

机构地区：[1]中山大学附属第一医院急诊科,广州510080

出　　处：《中华损伤与修复杂志（电子版）》2011年第5期18-21,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的通过两种压力模式作用于大鼠胫骨前肌引起肌组织缺血和血管损伤程度的比较,探讨波浪床预防深部组织损伤的机制。方法 10～12周龄SD大鼠20只,随机分为两组。每只大鼠取单侧后肢胫骨前肌中段部位0.2cm2,实验组给予渐变间歇性压力(8～21.3kPa),对照组给予持续性压力(13.3kPa)。实验组和对照组未施压一侧后肢作为健康对照。施压2h后间歇30分钟为1个周期,重复3个周期。施压3个周期后手术切开暴露胫骨前肌,采用微循环显微镜观察施压点边缘血管平均管径及平均流速,CD34免疫组化测量两组受压胫骨前肌组织微血管密度。结果施压后大体观察两组皮肤均无开放性溃疡形成,对照组胫骨前肌可肉眼见明显压痕并伴水肿、淤血,实验组损伤较轻微。微循环观测对照组肌肉平均血管管径,平均血流速度均较健侧下降,两组间差异有统计学意义(P<0.05)。CD34免疫组化测量微血管密度:实验组微血管密度比对照组高,比较两组差异有统计学意义(P<0.05)。结论渐变的间歇性压力可以减轻压力介导的组织缺血和血管损伤,预防深部组织损伤的形成。Objective In order to understand the mechanism of wave-bed prevention of deep tissue inury,we study two type, of pressure： sustained pressure and intermittent pressure produced by wave-bed effect on rat microcirculation of tibialis anterior muscle. Method Twenty Sprague-Dawley rats of 10-12 weeks old were randomly divided into two groups. Experimental and control groups of tibialis anterior muscle respectively received intermittent（8-21.3 kPa） and sustained （13.3 kPa） pressure on 0.2 cm2 area and heterolateral not-pressed for healthy control. The experiment was terminated after 3 cycles, and a single cycle included 2 hours of compression and 30 minutes of compression-release.To survey the average diameter of blood vessels and velocity of loaded tibialis anterior muscle by microcirculation microscope after 3 cycles compression, subcutaneous tissue microvessel density （MVD） was measured by CD34 immunohistochemistry. Results Skin edema was observed in both gorups. No skin ulcers occurrea. The average diameter of blood vessels and velocity of experimental group were decreased compared with the control group after compression and significant difference was found between two groups （P0.05）. CD34 immunohistochemistry IPP software showed that microvessel density of control goroup was decreased significantly and IOD showed significant differences between the two groups. Conclusions Intermittent gradient pressure can prevent the formation of deep tissue injury by reducing press induced ischemia,vascular endothelial cell injury.

关 键 词：软组织损伤 微循环 压力性溃疡 微血管密度 

分 类 号：R632.1[医药卫生—外科学]