摘要
目的:术后患肢的固定可削弱肌肉泵的作用,造成静脉血流缓滞,增加深静脉血栓形成的风险。通过对兔下肢行伸直位和屈髋屈膝位固定探讨其对兔股静脉血栓形成的影响。方法:实验于2003-10/2004-03在昆明医学院外科总论实验室和第一附属医院超声科完成。健康成年新西兰白兔60只,体质量(3.0±0.2)kg,雌雄不限。先行预实验,随机抽取12只,行耳缘静脉麻醉后人工固定兔左下肢伸直位与屈髋屈膝位(模拟石膏外固定),应用高频彩色多普勒血流显像仪观测,结果显示兔左下肢屈髋屈膝位可以引起血流速度减慢,血管内径变小,血流量降低。再将60只新西兰白兔随机分为两组,①固定组(n=30),行左下肢于屈髋屈膝位石膏外固定。②空白对照组(n=30),不作任何处理。于固定后5,7,9d两组动物行组织学观察,各时相点动物均为10只。主要观察:①高频彩色多普勒血流显像仪观测兔左下肢伸直位和屈髋屈膝位股静脉的血流速度和血管内径。②组织学观察两组兔左股静脉血栓发生情况。结果:纳入60只兔均进入结果分析。①固定为左下肢伸直位兔左股静脉的血流量为(0.064±0.015)cm3/s,左下肢固定为屈髋屈膝位时左股静脉血流量为(0.023±0.010)cm3/s,屈髋屈膝位较伸直位时血流速度减慢,血管内径变小,血流量降低(t=8.106,P<0.01)。②固定组5,7,9d左股静脉血栓发生率分别为20%,30%和10%;空白对照组均为0。固定组血栓发生率显著高于空白对照组(P<0.05)。结论:兔下肢在屈髋屈膝位时血流速度减慢,血管内径变小,血流量较伸直位时明显降低,更容易导致肢体深静脉血栓形成。
AIM:The fixation of postoperative affected limbs can weaken the action of mus cle pumps,slower the velocity of venous blood flow,and increase the incidence of deep vein thrombosis(DVT).This study aimed to investigate the influence of the fixation of extension of lower limbs and flexion of knee and hip joints on DVT i n rabbits. METHODS:The experiment was conducted in the General Laboratory for Surgery,Ku nming Medical College,and Department of Ultrasound in the First Hospital Affilia ted to Kunming Medical College from October 2003 to March 2004.Sixty healthy New Zealand adult rabbits in either gender weighing (3.0± 0.2) kg were selected.In the pre- experiment,intravenous anesthesia of marginal ear was performed to ma nually fix the extending lower limbs and flexing hip and knee joints of rabbits( simulated external fixation using plaster).With the help of high- frequency col or Doppler flow imager,the flexion of hip and knee joints of rabbits could slowe r blood flow velocity,contract inner diameter of blood vessel,and decrease blood flow.Then,the 60 New Zealand rabbits were randomly and equally divided into two groups:fixation group in which the flexing hip and knee joints of lower limbs w ere fixed using plaster,and blank control group treated with nothing.After fixat ion,behaviors were observed at 5,7 and 9 days respectively,10 animals in each gr oup at each time point.The observation indexes were ① blood flow velocity and i nner diameter of blood vessels of the extending left lower limbs and flexing hip and knee joints recorded using high- frequency color Doppler flow imager and② left femoral vein thrombosis observed histologically. RESULTS:All the 60 rabbits were included in the result analysis.① The blood flow of left femoral vein was (0.064± 0.015) cm3 per second in the extending le ft lower limbs,and (0.023± 0.010) cm3 per second in the flexing hip and knee jo ints.The blood flow velocity was slower,the inner diameter of blood vessels was shorter and the blood flow was less in the flexing hip and knee joints than in t he extending lower limbs(t=8.106,P< 0.01).② At 5,7 and 9 days,the incidence of left femoral vein thrombosis was 20% ,30% and 10% in the rabbits of fixatio n group respectively,and 0 in the control group,so it was significantly higher i n the former group than in the latter group(P CONCLUSION:Compared with the extension of lower limbs,the blood flow velocity is slowed down,the inner diameter of blood vessel is contracted,the blood flow decreases,and DVT attacks more easily in the flexion of hip and knee joints.
出处
《中国临床康复》
CSCD
北大核心
2005年第18期170-171,i007,共3页
Chinese Journal of Clinical Rehabilitation
