局部氧疗对高温复合伤大鼠创面肌肉组织影响的实验研究

目的探讨局部氧疗法对高温复合创伤大鼠创面肌肉组织的影响，为湿热环境的创伤伤口护理提供实验依据。方法建立24只大鼠腹部创伤模型，随机将其分为常温对照组、常温氧疗组、高温对照组和高温氧疗组4组，每组6只，让其分别接受常温暴露、常温氧疗、高温暴露和高温氧疗，然后进行光镜和透射电镜观察。结果高温对照组创面肌肉的组织形态和超微结构变化最为剧烈，肌纤维明显变性萎缩甚至变性坏死成碎片，毛细血管扩张充血明显，大量炎性细胞入侵组织，组织间隙水肿严重；大量的线粒体发生不可逆的空泡样变和髓样变，糖原颗粒剧减，巨噬细胞退变；高温氧疗组明显好于高温对照组，肌纤维仅肿胀而未发生萎缩变性，线粒体也未发生空泡样变，糖原颗粒与高温对照相比较多，可见少量未退变的巨噬细胞。结论高温复合创伤应激比单因素的创伤应激显，高温高湿环境创伤组织肌纤维损伤严重，局部氧疗法可降低高温高湿环境因素和创伤因素的损伤作用，从而延缓创面局部组织进一步的病理变化。

Experimental Study on the Effect of Topical Oxygen Therapy on Muscles of Rats Sustaining Compound Trauma in Hyperthermic Environment

Objective To investigate the influence of topical oxygen therapy on muscular wounds of rats in hot and humid environment.Methods Traumatic models were established in 24 rats,which were randomly divided into four groups,including normal environment comparison group(NEC group,n=6),normal environment oxygen therapy group(NEO group,n=6),hot and humid environment comparison group(HHE group,n=6),and hot and humid environment oxygen therapy group(HHO group,n=6).Then all rats were sampled to observe changes of muscle under an optical microscope and electron microscope.Results Pathohistology of muscle cells was obviously changed in HHE group, where swollen mitochondria with cristae loss and vacuolization, deranged myofibrillae with some loss of myofilaments, reduced glycogen granules, and degenerated macrophages were seen. Damage to muscle fibers in HHO group was not so serious as that in HHE group. Damage to muscle cells in NEC group was slighter than that in HHE group. The ultrastructure of muscle cells in NEO group was normal.Conclusion In hot and humid environment, pathohistologic changes of wounds were more serious, and topical oxygen therapy could attenuate ultrastructural changes of muscle tissues.