负压吸引预防兔挤压综合征

摘要

Objective To establish an animal model of crush syndrome in rabbits and investigate the preventive effect of negative pressure drainage.Methods Twenty-four New Zealand rabbits were randomly divided into four groups:control group,traditional treatment group,negative-pressure treatment group and mixed treatment group,with six rabbits per group.Blood urea nitrogen (BUN),creatinine (Cr),K,creatine kinase (CK) and myoglobin (Myo) were detected before crush and at 6,12,24,48,72 hours after decompression.Edema and analgesia of extremities were determined and changes of kidney and muscular tissue were observed by light microscope.Results As time went on,K,Myo,BUN and CR had unobvious rise in each treatment group,without the presence of renal failure.The control group showed marvelous increases of K,Myo,BUN and Cr at 6 hours after decompression,from (4.61 ±0.98)mmol/L,(4.22±0.93) ng/ml,(7.76±1.40) mmol/L,(101.32±9.35)μmol/Lto (7.88±1.95)mmol/L,(11.34 ±3.86) ng/ml,(15.91 ± 1.76) mmol/L,(258.32 ±91.40) μmol/L separately,with renal failure and significant differences in comparison with other treatment group (P ＜0.05).The level of tissue edema and degree of analgesia in negative-pressure treatment group and mixed treatment group were lower than those in the traditional treatment group.Renal damage in all the treatment groups was milder than that in the control group by light microscopic observation,while there was no significant difference of muscle injury among groups.Conclusion Negative pressure drainage may prevent crush syndrome.%目的 制作挤压综合征模型以探讨负压吸引对挤压综合征的预防作用. 方法 24只新西兰白兔按随机数字表法分为对照组、传统治疗组、负压治疗组、传统加负压治疗组,每组6只,于挤压前和解压后6,12,24,48,72 h检测血尿素氮(BUN)、肌酐(Cr)、血钾(K)、肌酸激酶(CK)及肌红蛋白(Myo).检测局部肢体水肿程度和痛觉丧失程度,光镜下观察肾脏和肌肉组织的变化情况. 结果 各治疗组随时间的推移K、Myo无明显上升,BUN和CR未见明显增高,未发生肾功能衰竭.对照组在解压后6hK、Myo、BUN、Cr含量从挤压前的(4.61-0.98) mmol/L、(4.22-0.93) ng/ml、(7.76±1.40) mmol/L、(101.32±9.35) μmol/L分别增加至(7.88±1.95) mmol/L、(11.34±3.86) ng/ml、(15.91±1.76) mmol/L、(258.32 ±91.40) μmol/L,与各治疗组比较差异有统计学意义(P＜0.05),发生了肾功能衰竭.负压治疗组和传统加负压治疗组组织水肿程度和痛觉丧失程度较传统治疗组低.光镜下见各治疗组肾脏损伤程度较对照组低,局部肌肉损伤各组之间无明显差别. 结论 负压吸引可以预防挤压综合征的发生.