CAJ | 학술논문

目的通过观察间歇性渐变压力模式及持续性压力模式作用大鼠胫骨前肌所引发的灌注障碍及肌纤维损伤程度,从而探讨间歇性渐变压力模式在防治深部组织损伤中的相关机制.方法共选取10～12周龄SD大鼠20只,采用随机数字表法将其分为实验组及对照组.实验组大鼠胫骨前肌部位给予间歇性渐变压力(压力范围8.0 ～ 21.3 kPa)作用,对照组相同部位则给予持续性压力(压力范围为13.3 kPa)作用,每施压2h则间歇0.5h(为1个周期).于施压3个周期后观察各组大鼠受压部位皮肤及肌肉大体情况,同时采用激光多普勒血流灌注成像系统检测2组大鼠后肢受压点皮肤血液灌注情况；观察完毕后切开皮肤,采用相同方法重复检测2组大鼠胫骨前肌受压点30 min内的动态血液灌注情况；最后于2组大鼠胫骨前肌受压部位取材,进行磷钨酸苏木素染色(PTAH)以观察肌肉损伤情况.结果待3个周期施压结束后,发现治疗组大鼠受压部位皮肤血流及肌肉灌注情况均显著优于对照组,组间差异均具有统计学意义(P＜0.05).随着时间推移,实验组及对照组受压部位血流速度均有增加趋势,并以实验组的增加幅度较显著,与对照组间差异具有统计学意义(P＜0.05).对2组大鼠PTAH染色结果比较后发现,实验组大鼠受压部位肌肉损伤程度明显轻于对照组(P＜0.05).结论与持续性压力模式比较,间歇性渐变压力作用能明显减轻压力诱发的组织缺血缺氧及肌组织压力性损伤,对防治深部组织损伤具有重要意义.
목적 통과관찰간헐성점변압력모식급지속성압력모식작용대서경골전기소인발적관주장애급기섬유손상정도,종이탐토간헐성점변압력모식재방치심부조직손상중적상관궤제.방법 공선취10～12주령SD대서20지,채용수궤수자표법장기분위실험조급대조조.실험조대서경골전기부위급여간헐성점변압력(압력범위8.0 ～ 21.3 kPa)작용,대조조상동부위칙급여지속성압력(압력범위위13.3 kPa)작용,매시압2h칙간헐0.5h(위1개주기).우시압3개주기후관찰각조대서수압부위피부급기육대체정황,동시채용격광다보륵혈류관주성상계통검측2조대서후지수압점피부혈액관주정황；관찰완필후절개피부,채용상동방법중복검측2조대서경골전기수압점30 min내적동태혈액관주정황；최후우2조대서경골전기수압부위취재,진행린오산소목소염색(PTAH)이관찰기육손상정황.결과 대3개주기시압결속후,발현치료조대서수압부위피부혈류급기육관주정황균현저우우대조조,조간차이균구유통계학의의(P＜0.05).수착시간추이,실험조급대조조수압부위혈류속도균유증가추세,병이실험조적증가폭도교현저,여대조조간차이구유통계학의의(P＜0.05).대2조대서PTAH염색결과비교후발현,실험조대서수압부위기육손상정도명현경우대조조(P＜0.05).결론 여지속성압력모식비교,간헐성점변압력작용능명현감경압력유발적조직결혈결양급기조직압력성손상,대방치심부조직손상구유중요의의.
Objective To compare the impacts of sustained and intermittent gradient pressure on perfusion disorders and myofiber injuries and to explore the mechanism by which intermittent gradient pressure helps treat deep tissue injury (DTI). Methods Twenty Sprague-Dawley rats 10-12 weeks old were randomly divided into an experimental group and a control group.The tibialis anterior muscles of the experimental group received intermittent fluctuating pressure at 8.0-21.3 kPa while the control group received sustained pressure at 13.3 kPa.The contralateral notpressed muscles served as healthy controls.The experiment was terminated after 3 cycles of compression where each cycle involved 2 h of compression and 30 min of conpression release.The general condition of the rats'skin and muscles in the compressed region were observed and laser doppler perfusion imaging was used to detect blood perfusion of the skin of the compressed leg after 3 cycles of compression.Any pathomorphological changes in the tibialis anterior muscles of the compressed region were observed by phosphotungstic acid hematoxylin (PTAH) staining. Results Blood perfusion of the skin and muscle in the control group was significantly less than in the experimental group after compression,and blood flow velocity increased with time in both groups.However,perfusion was significantly more extensive in the experimental group.PTAH staining showed that muscle injury in the experimental group was significantly less severe than in the control group. Conclusion Compared to the sustained pressure,intermittent pressure cause significantly less severe DTI by reducing compression-induced ischemia and hypoxia.