不同挤压压力与大鼠挤压伤严重程度的相关性  

Correlation between the severity of crush injury in rats and the different crushing force

作　　者：王鑫[1,2] 吕琪[2] 丁辉[2] 刘子泉[2] 曾喜欢 王敬[2] 侯世科[2] WANG Xin;LYV Qi;DING Hui;LIU Ziquan;ZENG Xihuan;WANG Jing;HOU Shike(Specialty of Emergency Medicine,Xinxiang Medical University, Xinxiang 453003, China;Institute of Disaster Medicine and Public Health, Affiliated Hospital of Logistic University of Chinese People's Armed Police Force, Tianjin 300162, China)

机构地区：[1]河南省新乡医学院,453003 [2]武警后勤学院附属医院救援医学研究所,天津300162

出　　处：《中华灾害救援医学》2017年第4期181-185,共5页Chinese Journal of Disaster Medicine

基　　金：十三五重点研发计划(2016YFC0802806);天津市科技计划课题(15ZXLCSY00040,15PTGCCX00130)

摘　　要：目的初步探讨不同挤压压力与大鼠挤压伤严重程度的相关性。方法将127只雄性Wistar大鼠随机分为对照组(15只)、模型组(56只)、治疗组(56只)。模型组和治疗组大鼠均分别用3 kg及5 kg压力挤压双下肢16 h,治疗组于解压前1 h给予常规无菌生理盐水补液治疗,1 ml/(kg·h),至解压后6 h完成补液。留取造模或治疗后24 h、72 h血液样本及肌肉组织样本进行血生化及湿干重比检测;留取72 h各组组织样本进行组织病理学评估;记录各组72 h生存率。结果模型组大鼠解压24 h后血生化指标钾离子(potassium ions,K+)、肌酸激酶(creatine kinase,CK)、尿素氮(blood urea nitrogen,BUN)、肌酐(creatinine,Cr)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(aspartate transaminase,AST)均升高,与对照组比较(P<0.001);与3 kg压力组比较,5 kg压力组血清各指标水平均升高显著(P<0.01)。5 kg压力组可观察到大片横纹肌溶解、广泛的肾小管管型,远隔器官肺组织出现局灶性炎性细胞浸润及肺泡间隔增厚,但肌肉水肿及72 h生存状况两组之间无差异;给予常规补液治疗后,两不同压力组血生化指标变化不大,但病理损伤减轻,肾小管管型减少;5 kg压力组未观察到大范围肌细胞坏死溶解、肺泡间隔增厚,炎性细胞渗出亦减轻,但其死亡率并未改善。而与模型组相比,3 kg压力组死亡率减少(P=0.047)。补液后由于灌注量增加,肌肉湿干重比也随之增加。结论在一定范围内挤压伤严重程度与挤压压力呈正相关。Objective This study aimed to identify the correlation between the severity of crush injury and the different crushingforce.Methods A total sample of127male Wistar rats were randomly divided into a control group(n=15),crush injury group(n=56)andtreatment group(n=56).Rats in crush injury and treatment groups suffered bilateral hind limbs crushed with3kg and5kg forces for16hrs,the treatment group received1ml/(kg·h)conventional rehydration treatment for6hrs following the release of the compressive force.Bloodand muscle tissue samples were collected at24hrs and72hrs after the release of the compressive force for testing of biochemical parametersand the wet dry ratio;tissue samples of each group for histopathologic evaluation was collected at72hrs after release of the compressive force;the72hr survival rate of each group was recorded.Results Biochemical indicators[potassium ions(K+),creatine kinase(CK),blood ureanitrogen(BUN),creatinine(Cr),alanine transaminase(ALT)and aspartate transaminase(AST)]in the crush injury group were all significantlyincreased24hrs after release of the compressive force(P<0.001)as compared to the control group;the levels of serum biochemical indicatorsin the5kg group were significantly higher24hrs after the release of the compressive force compared with3kg group(P<0.01).A large part ofrhabdomyolysis and a wide range of renal casts could be found in the5kg group,and focal inflammatory cell infiltration and interval thickeningappeared in its remote organ lung,but there was no difference in muscle swelling and the72hr survival rate between the3kg and5kg forcegroups;after receiving conventional rehydration treatment,the biochemical indicators of the3kg and5kg groups showed little change,howeverpathological damage was less,renal casts were reduced;a wide range of muscle-cell necrosis and the thickening of alveolar septum were notfound in5kg group,and its inflammatory cell infiltration was also reduced,but the survival rate was not improved.Compared with the crushinjury group,the mortality rate w

关 键 词：挤压伤 不同挤压力 损伤严重程度 补液治疗 

分 类 号：R642[医药卫生—外科学]