氧合血灌注对离断肢体保护作用实验研究  

Experimental study on the protective effect of oxygenated blood perfusion on amputated limbs

作　　者：胡进 孙中洋 王国军 HU Jin;SUN Zhong-yang;WANG Guo-jun(Department of Anesthesiology,Shanghai Ninth People′s Hospital,Shanghai 200011,China;Department of Orthopedic,Air Force Hospital of Eastern Theater Command,Nanjing 210002,China;Department of Anesthesiology,Air Force Hospital of Eastern Theater Command,Nanjing 210002,China)

机构地区：[1]上海第九人民医院麻醉科,上海200011 [2]东部战区空军医院骨科 [3]东部战区空军医院麻醉科,江苏南京210002

出　　处：《临床军医杂志》2025年第3期221-224,共4页Clinical Journal of Medical Officers

基　　金：“打仗型”医院建设专项课题(22DZ-002YB)。

摘　　要：目的探讨氧合血间断灌注在兔离断肢体保护中的作用。方法选取24只健康新西兰大白兔,雌雄不限,体质量2.0~2.5 kg,将其随机分为对照组(C组)、单纯低温组(T组)、氧合血灌注组(O组),每组各8只。C组不做处理;T组离断肢体低温保存8 h;O组肢体离断4 h后氧合血间断灌注4 h。各组分别于离断后肢模型建立后0、4、8、12、24 h取其胫前肌测定肌肉组织中丙二醛(MDA)、谷丙转氨酶(ALT)、葡萄糖(GLU)、髓过氧化物酶(MPO)的含量。结果随着肢体离断的时间延长,各组MDA、MPO、ALT含量呈上升趋势,各组GLU含量呈下降趋势。C组8、12、24 h的MDA、MPO、ALT均高于0 h,GLU均低于0 h;T组12、24 h的MDA、MPO、ALT均高于0 h,GLU均低于0 h;O组24 h的MDA、MPO高于0 h,GLU低于0 h,差异均有统计学意义(P<0.05)。T组4、8、12、24 h的MDA、MPO、ALT均分别低于C组各时间点,GLU均分别高于C组各时间点;O组8、12、24 h的MDA、MPO、ALT分别低于C组各时间点,GLU均分别高于C组各时间点,差异均有统计学意义(P<0.05)。O组12、24 h的MDA、MPO、ALT均低于T组,8 h的ALT高于T组,8、12、24 h的GLU均高于T组各时间点,差异均有统计学意义(P<0.05)。结论氧合血灌注离断肢体可一定程度减轻离断肢体损伤,有利于延长离断肢体保存时限,可为临床中离断肢体的保护提供一定的治疗方向。Objective To investigate the effect of intermittent oxygenated blood perfusion on the protection of severed limbs in rabbits.Methods Twenty-four healthy New Zealand white rabbits,male and female,with body weight of 2.0-2.5 kilograms,were randomly divided into control group(group C),simple hypothermia group(group T)and oxygenated blood perfusion group(group O),with 8 rabbits in each group.Group C was not processed.The severed limbs of group T were kept at low temperature for 8 hours.Group O was injected with oxygenated blood for 4 hours after limb amputation.The contents of malondialdehyde(MDA),alanine aminotransferase(ALT),glucose(GLU)and myeloperoxidase(MPO)in muscle tissue of the anterior tibial muscle of each group were measured at 0,4,8,12 and 24 hours after the establishment of amputated hind limb model.Results The contents of MDA,MPO and ALT increased and the content of GLU decreased with the extension of limb dismemberment time.MDA,MPO and ALT of group C at 8,12 and 24 hours were higher than 0 hour,and GLU was lower than 0 hour(P<0.05).MDA,MPO and ALT of group T were higher than 0 hour at 12 and 24 hours,and GLU was lower than 0 hour,with statistical significance(P<0.05).MDA and MPO at 24 hours were higher than 0 hour,and GLU was lower than 0 hour in group O,and the differences were statistically significant(P<0.05).MDA,MPO and ALT of group T at 4,8,12 and 24 hours were lower than those of group C,and GLU was higher than those of group C at all time points(P<0.05).MDA,MPO and ALT in group O at 8,12 and 24 hours were lower than those in group C,and GLU was higher than those in group C,with statistical significance(P<0.05).MDA,MPO and ALT of group O at 12 and 24 hours were lower than those of group T,ALT at 8 hours was higher than that of group T,and GLU at 8,12 and 24 hours were higher than those of group T at all time points,with statistical significance(P<0.05).Conclusion Oxygenated blood perfusion can reduce the injury of severed limbs to a certain extent,is conducive to extending the preservation time o

关 键 词：离断肢体保护 氧合血 低温 

分 类 号：R614[医药卫生—麻醉学]