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。

Dynamic alteration of skin microcirculation and effect of pentoxifylline on rabbits after experimental high-voltage electrical burn

Objective To observe the changes of skin microcireulation perfusion discharge （MPD） and the effect of pentoxifylline on rabbits after high-voltage electrical burn （HEB）. Methods Forty five rabbits were divided into control group, electrical burn group and pentoxifyliine treatment group in a simple random method, with 15 rabbits in each group. Rabbit model of HEB was reproduced from electrical burn with the TC-30-20KVA type vohage regulator and YDJ-10KVA type transformer. The control group was not electric shock. The LISCA Laser Doppler Hemoperfusion image instrument （LDPI） was used to observe the changes of skin MPD at 5 minutes before the HEB, 5 minutes, 1 hour, 2 hours, 4 hours and 8 hours later. The locations observed were wound surface skin of left forelimb and right hindlimb, normal skin of right forelimb and left hindlimb. Results （ 1 ） The MPD of wound surface and normal skin in four limbs of electricalburn group and pentoxifylline treatment group after HEB were discreased, compared with that before HEB. At 5 minutes after HEB, the skin MPD of left forelimb of electrical burn group and pentoxifylline treatment group were （0.66 ±0.13） V, （1.62 ±0.27） V, but they were （0.59 ±0.12） V, （1.50 ±0.23） V in left bindlimb. These values were less than before HEB （3.21 ±0.22）, （3.24 ±0.25）, （3.06 ±0.24）, （3.01 ±0.22） V]. （2） Compared with the same group right limbs in electrical burn group and pentoxifylline treatment group, the MPD of wound surface in left limbs was less than normal skin. （ 3 ） The MPD of wound surface and normal skin in electrical burn group was less than control group. Pentoxifylline treatment group and electrical burn group had the same tendency. （4） The MPD of normal skin in pentoxifylline treatment group was more than electrical burn group after HEB. Compared with the MPD of wound surface, there were not significant differentces. Conclusions The MPD of wound surface and normal skin decreases after HEB. Pentoxifylline can improve MPD of normal skin, but show no effect on wound surface skin.