筋膜切开减压术治疗挤压综合征家兔模型的实验研究

目的:观察筋膜切开减压术在挤压综合征家兔模型的治疗中能否起到积极作用,并指导临床救治工作。方法:选取健康成年新西兰家兔(不分雌雄)70只。随机分为未行切开减压的实验对照组(10只)和切开减压组(即减压组60只),2组均在挤压4 h后解压,减压组根据解压后行筋膜切开减压时间将其分为6个亚组(每个亚组10只):即刻切开组(0 h)、2 h后切开组、4 h后切开组、6 h后切开组、8 h后切开组及10 h后切开组,分别标为A-F组,对照组设为G组;测量A-G组挤压4 h后及减压组(A-F组)减压术后第2 h、6 h、12 h的静脉血,检测血BUN、Cr、AST、ALT、CK、CK-MB、K~+、Ca~(2+)、MYO等生化指标;24小时后取挤压处的肌肉、肾脏、肝脏、心肌并立即做切片处理,并在光镜下进行检测分析。结果:两组挤压后4 h血BUN、Cr、AST、ALT、CK、CK-MB、K+、Ca2+、MYO差异无统计学意义(P0.05);两组资料具有可比性。挤压伤组与对照组在各时间点生化指标差异均无统计学差异(P0.05);各亚组之间在相同时刻生化指标也无统计学差异(P0.05)。各亚组内随时间变动其BUN、Cr、AST、ALT、CK、CK-MB指标均呈上升趋向;而差异K~+、Ca~(2+)、MYO指标呈下降趋势;有统计学意义(P0.05),有一定的时间依赖性。结论:早期行筋膜切开减压术在挤压综合征家兔模型的早期治疗中无明显的疗效;筋膜切开减压术并不可以改善患机体全身多脏器损伤情况。

To Explore the Curative Effect of Incision Decompression to Crush Syndrome of Rabbit Model

ABSTRACT Objective: Aim to observe the treatment effect of Fascia incision decompression in the crush syndrome of rabbit model, which could guide the clinical treatment. Methods: A total of 70 healthy adult New Zealand rabbits (both male and female) were selected, Randomly divided into control group without Incision decompression (10) and Incision group (60).In crush injury group the Squeezed limb was decompression after extrusion 4 hours, then according the times of Fascia incision decompression, we divided into six sub- groups(10 in each group): 0 hour, after 2 hours, after 4 hours, after 6 hours, after 8 hours, labeled A - F group, Respectively, control group is set to group G. Measuring BUN, Cr, AST, ALT, CK, CK - MB, K⁺, Ca²⁺ and MYO in group A - G after decompression 4 hours and In- cision group(group A - F) after Incision decompression 2 hours, 6 hours and 12 hours. After 24 hours the location of the extrusion quadri- ceps, kidneys, liver, myocardium were taken for pathological analysis. Results: The BUN, Cr, AST, ALT, CK, CK - MB, K⁺, Ca²⁺, MYO after decompression 4 hours and at various time points after Incision decompression had no statistical significance in Incision group(in- cluding subgroups) and control group (P>0.05); Crush injury group and the control group at various time points and biochemical index difference had no statistical difference (P>0.05); The biochemical index such as BUN, Cr, AST, ALT, CK, and CK-MB was rising over the time in each subgroups and K⁺, Ca²⁺, MYO was decline, On the contrary(P<0.05). Conclusion: There is no obvious curative effect in the rabbit model with crush syndrome for incision decompression treatment in early time and multiple organ injury has no significance.