高压电烧伤家兔牙龈微循环变化及己酮可可碱疗效

目的观察高压电对家兔牙龈微循环灌流量(MP)的影响并探讨己酮可可碱(PTX)的干预作用。方法将45只家兔按完全随机设计方法分为对照组、电伤组和治疗组,每组15只。电伤组和治疗组家兔用调压器和实验变压器制成高压电烧伤模型,对照组家兔接相同装置但不通电,致假伤。用激光多普勒微循环图像仪检测3组家兔伤前15min、伤后5 min、1 h、2 h、4 h、8 h牙龈MP。检测部位为家兔上颌门齿唇侧牙龈黏膜表面。结果①伤后与伤前组内比较:电伤组和治疗组伤后5 min牙龈MP分别是(1.64±0.38)V、(1.56±0.33)V,均大于伤前的(1.32±0.30)V、(1.34±0.28)V,在伤后各时相点中变化幅度最大,呈升高趋势;之后各时相均低于伤前,呈下降趋势。②电伤组、治疗组与对照组比较:电伤组伤后5 min牙龈MP高于对照组,伤后1～8 h各时相点均低于对照组;治疗组变化类似电伤组。③治疗组与电伤组比较:伤后5 min、1 h、2 h牙龈MP与电伤组差异无统计学意义,伤后4 h、8 h牙龈MP均高于电伤组。结论高压电烧伤导致家兔牙龈微循环障碍。PTX可提高电伤后牙龈MP。     

梗阻性黄疸大鼠肾皮质微循环变化及意义

目的探讨梗阻性黄疸大鼠肾皮质微循环变化及意义。方法SD大鼠48只分为假手术对照组(SO组)和胆总管结扎组(BDL组)各24只,每组再分别于术后3d、7d、10d各取8只大鼠,应用WX-9型微循环显微镜观测大鼠肾皮质微血管管径和密度变化及微血管周围的渗出情况。应用LISCA激光多普勒组织灌流图像仪观测各组大鼠肾皮质血液灌流量的变化。结果BDL组胆总管结扎后,肾皮质微血管收缩,血液灌流值减小,7d、10d时微血管数量减少,且随胆道梗阻时间延长变化更加明显(P<0.05,P<0.01),微血管周围出现渗出。SO组各时点上述指标均无显著变化。结论梗阻性黄疸可引起大鼠肾皮质微循环障碍,血液灌流量减少,并随梗阻时间延长而加重。     

高压电烧伤对大鼠TNF-α及微循环的影响

目的检测高压电对大鼠血清肿瘤坏死因子-α（TNF-α）、皮肤微循环灌流量（SMH）的影响并探讨TNF-α在微循环障碍中的作用及乌司他丁（UTI）的干预效果。方法将144只SD大鼠按完全随机设计方法分为对照组、电伤组和治疗组,每组48只,每组再分为6个时相组,每时相组8只。电伤组和治疗组大鼠用调压器和实验变压器制成高压电烧伤模型,对照组大鼠接相同装置但不通电,致假伤。用ELISA法检测三组伤前15 m in及伤后5 m in、1 h、2 h、4 h、8 h大鼠血清TNF-α变化,用激光多普勒微循环图像仪检测以上各时相胸部SMH。结果①TNF-α变化：组内比较,电伤组和治疗组TNF-α在伤后5 m in上升,持续至伤后8 h,均呈逐渐升高趋势,伤后8 h达最高值,分别为（54.71±4.82）、（24.26±3.17）pg/m l;组间比较,治疗组TNF-α在伤后5 m in较电伤组无明显变化,从伤后18 h,治疗组TNF-α均低于电伤组,高于对照组。②SMH变化：组内比较,电伤组和治疗组SMH在伤后5 m in开始下降,持续到伤后8 h,均呈逐渐下降趋势,均以伤后5 m in最低值,分别是（1.01±0.05）V、（1.12±0.11）V;组间比较,治疗组SMH在伤后5 m in8 h,SMH均高于电伤组,低于对照组。结论高压电可引起大鼠血清TNF-α升高及SMH下降,而UTI能抑制伤后血清TNF-α升高和SMH下降。TNF-α在高压电烧伤后微循环障碍中起一定作用     

高压电烧伤家兔球结膜微循环变化和己酮可可碱干预作用

Objective To study the changes in bulbar conjunctiva microcirculation (BCM) and the therapeutic effect of Pentoxifylline on BCM disturbance after high-voltage electrical burn (HEB) in rabbits. Methods Forty-five rabbits were divided into control group (C) , electrical burn group (EB) , and Pentoxifylline treatment group (PT) according to random number table, with 15 rabbits in each group. Model of HEB was reproduced in rabbits from EB and PT groups with voltage regulator and experimental transformer. Rabbits in C group were sham injured with the same devices without electrification. Changes in BCM were observed with microcirculation microscope at 15 minutes before HEB and 5 minutes, 1, 2, 4, 8 hour (s) post HEB (PHM or PHH) , including: (1) morphology of microvessels, such as the descemibleness, diameters of arterioles, venules, and capillaries, the unevenness in caliber, and ischemic area; (2) dynamic changes in microvascular blood flow, such as blood flow speed in arterioles, venules, and capillaries, erythrocyte aggregation, and microthrombi formation; (3) condition of tissues surrounding microvessel, such as bleeding and exudation. Measurement data were processed with t test; enumeration data were processed with Fisher's exact test. Results (1) Morphology of microvessel: descernibleness of microvessels in EB and PT groups was decreased, but that of PT group was better than that of EB group. At PHM 5 , diameter of ar-terioles, venules and capillaries was respectively (7. 3 ± 2. 5) , (12. 3 ± 2. 4) , (3. 5 ± 0. 7) μm in EB group, all narrower than those of the control group [(14.6 ±3. 1) , (27.2±3.5), (9.0±1.4) μm, with t value respectively 5. 23 , 13. 66, 14. 04, P values all below 0. 05]. Diameters of the microvessels in PT group [(10. 2 ±3.8) , (21.5±3.1), (7. 1 ±1.2) μm] were larger than those in EB group (with t value respectively 2. 21 , 8. 99, 10. 18, P values all below 0. 05). Diameters of arterioles, venules and capillaries in EB and PT groups recovered to the before HEB size at PHH 1. From PHH 2 to 8, arterioles and capillaries decreased gradually in caliber, venules dilated gradually in EB and PT groups, but the changes in PT group were not obvious. Thickness of microvessel was observed uneven in EB group at PHM 5, which lasted until PHH 8. Ischemia of the tissue was observed in EB group at PHM 5, which improved at PHH 2. Situation in PT group was better. (2) Dynamic changes in microvascular blood flow; at PHM 5, blood flow speed in arterioles, venules and capillaries was respectively (202 ±53), (198 ± 44) , (46 ±12) μm/s in EB group, all slower than those of the control group [(544 ± 37) , (359 ± 32) , (220 ± 19) μm/s, with t value respectively 20.47, 11. 51, 30. 02, P values all below 0.05] , and those of PT group [(335 ± 42) , (260 ± 35), (119 ± 23) μm/s] were faster than those of EB group (with t value respectively 7. 55 , 4. 26, 14. 85, P values all below 0.05). Blood flow speed in EB and PT groups recovered to the before HEB level at PHH 1. From PHH 2 to 8, blood flow speed decreased gradually in EB and PT groups, but that of PT group was faster than that of EB group. Erythrocyte aggregation in venules and capillaries was observed in EB group at PHM 5, which eased up at PHH 1 , but aggregated at PHH 2, lasting until PHH 8. Obvious microthrombi were observed in EB group at PHH 2, which increased gradually. These changes were less obvious in PT group. (3) Condition of surrounding tissues of microvessel: in EB group, exudation was observed around microvessels at PHH 1, bleeding at PHH 2, with a worsening tendency. Changes in those in PT group were less obvious. Conclusions HEB causes disturbance in BCM, but it can be ameliorated by Pentoxifylline.     

高压电烧伤家兔皮肤微循环灌流量变化及己酮可可碱的干预作用

目的观察高压电对家兔皮肤微循环灌流量(MPD)的影响并探讨己酮可可碱(PTX)的干预作用。方法将45只家兔按完全随机设计方法分为对照组、电伤组和治疗组,每组15只。电伤组和治疗组家兔用调压器和实验变压器制成高压电烧伤模型,对照组家兔接相同装置但不通电,致假伤。用激光多普勒微循环图像仪检测3组家兔伤前5min、伤后5min、1h、2h、4h、8h皮肤MPD。检测部位为左前肢和右后肢创面皮肤、右前肢和左后肢正常皮肤。结果 (1)电伤组和治疗组伤后四肢正常皮肤及创面MPD均较电伤前下降。伤后5min,电伤组及治疗组右前肢皮肤MPD分别是(0.66±0.13)V、(1.62±0.27)V,左后肢皮肤MPD分别是(0.59±0.12)V、(1.50±0.23)V,均小于伤前的(3.21±0.22)V、(3.24±0.25)V、(3.06±0.24)V、(3.01±0.22)V,在伤后各时相点中下降的幅度最大,之后虽有所回升,但一直低于伤前;伤后5min,电伤组及治疗组左前肢创面MPD分别是(0.16±0.10)V、(0.17±0.13)V,左后肢创面MPD分别是(0.18±0.11)V、(0.19±0.11)V,均小于伤前的(3.19±0.27)V、(3.23±0.24)V、(3.09±0.22)V、(3.03±0.25)V,之后持续降低。(2)电伤组和治疗组组内左右肢体比较,伤后各时相点创面MPD均明显低于对侧皮肤MPD。(3)组间同肢体同时相点与对照组比较,电伤组伤后各时相点皮肤和创面MPD均低于对照组;治疗组变化同电伤组。(4)组间同肢体同时相点治疗组与电伤组比较,治疗组伤后各时相点皮肤MPD高于电伤组;而创面MPD与电伤组差异无统计学意义。结论高压电烧伤导致家兔远隔皮肤及创面皮肤MPD下降,PTX可提高电伤后远隔皮肤MPD,对创面MPD无明显作用。     

亚健康人微循环紊乱及其临床意义

目的通过研究亚健康人足甲襞微循环变化,探讨人体微循环紊乱在亚健康发生和发展过程中的作用。方法用WX-9型微循环显微镜及微循环图像分析系统,观测100例临床诊断为亚健康人（亚健康组）的足甲襞微循环,并与100名健康人（健康组）对照。亚健康组男50例,女50例,平均年龄38．54±15．67岁;健康组平均年龄37．37±14．83岁．观察指标包括微血管形态、微血流动态、微血管周围状态共三方面17项指标。结果亚健康组与健康组比较,前者微血管清晰度降低,管襻数减少,输入枝及输出枝长度缩短,输入枝、输出枝和襻顶直径变小,血流速度减慢．红细胞聚集性增高,襻周有渗出和出血。结论亚健康人外周微循环有明显紊乱,表明微循环紊乱在亚健康发生发展过程中起重要作用。     

高压热塑料喷射致手掌冲击伤和热损伤一例

患者男，48岁，塑料厂工人，既往健康。工作中不慎被高压喷塑枪喷出的高压热塑料液体击中左手掌内侧，喷塑枪压力约300kPa，塑料温度约140℃。患者伤后30min急诊入院治疗。入院时患者神智清楚，表情痛苦，步人病房，体检：体温36．5℃，     

烧伤脓毒症患者伴行股动脉、股静脉血气变化研究

目的探讨烧伤脓毒症患者伴行股动脉、股静脉血气指标检测的意义。方法总结22例特重度烧伤脓毒症患者（脓毒症组）和43例特重度烧伤未出现脓毒症患者（对照组）的资料,比较2组患者股动脉及股静脉血气指标的变化。结果动脉血气分析:脓毒症组碳酸氢根离子（HCO₃^-）值低于对照组。静脉血气分析:脓毒症组中股静脉血二氧化碳分压[p（CO₂）]高于对照组,股静脉血氧饱和度（SvO₂）、HCO₃^-低于对照组（均P<0.01）。脓毒症组动、静脉氧分压[p（O₂）]差值[Δp（O₂）],动、静脉p（CO₂）差值[Δp（CO₂）],动、静脉HCO₃^-差值（ΔHCO₃^-）,动、静脉血氧饱和度差值（ΔSO₂）均高于对照组（均P<0.01）。结论烧伤脓毒症患者股静脉血气指标改变明显,检测股动脉和股静脉血气利于烧伤脓毒症的早期判断。     

烧伤复合爆炸伤合并胸壁金属异物治愈1例

患者,男性,20岁,主因化学物质爆炸致全身多处烧伤伴躯干皮肤破损、呼吸困难1h来院.入院查体,神志清楚,痛苦面容.T 36.2℃,P 120次/min,R 23次/min,Bp 20/12kPa,左肺呼吸音不清,右肺呼吸音尚可,心音有力,未闻及杂音,腹软无压痛、反跳痛,肝脾未触及.双侧巴氏征阴性.专科情况,烧伤创面主要位于头面颈、躯干及双上肢,共计约 25%体表面积(total body surface area,TBSA),大部分表皮剥脱,基底红白相间,末梢循环差.