血液稀释对再植兔耳血液循环的影响

目的 探讨血液稀释对兔耳再植组织血液动力学的影响。方法 成年雄性家兔10只,随机分为2组:A空白对照组,B稀释组。各组复制再植模型并进行相应处理,动态监测并比较处理前(T0)及处理后1h(T1)、12h(T2)、24h(T3)、48h(T4)的应激激素水平:血浆肾上腺素、去甲肾上腺素;再植组织血流指标:皮肤的张力、颜色,与健侧同部位组织的温度差,皮瓣毛细血管充盈时间,再植兔耳血液灌注容积波,面积及术后凝血指标。结果 (1)2组处理后各时间点肾上腺素水平明显高于处理前(P均<0.05);且处理后各时间点B组肾上腺素水平低于A组(P均<0.05)。2组处理后各时间点去甲肾上腺素水平明显高于处理前(P均<0.05);但处理后各时间点2组间的水平无统计学差异(P均>0.05)。(2)B组较A组血小板计数、纤维蛋白原降低(P均<0.05),凝血酶原时间、活化部分凝血酶原时间均延长(P均<0.05)。(3)2组动物再植耳较对侧耳温度呈短时间内先升高、后下降的趋势,在12h后波动不大。平均各时间点温度差A组较B组大(P均<0.05);毛细血管充盈时间表现为A组>B组;T1、T3、T4的SpO2容积波面积大小差异有统计学意义(P<0.05)。结论 血液稀释可以显著改善再植兔耳组织的血液循环。

Effect of hemodilution on blood circulation of replanted rabbit ear

Objective To investigate the impact of hemodilution on hemodynamics of replanted tissues of rabbit ear. Methods Ten adult male rabbits were randomly divided into two groups(n=5 each): control group(group A) and dilution group (group B) after establishing animal model of replantation of served ear. The hemodilution was made by injecting 6% hydroxyethylstarch into ear vein in group B, and no treatment was given in group A. The levels of stress hormones (adrenaline, noradrenaline), the hemodynamic indexes (tension and color of skin, temperature difference of the same site tissues between affected lateral and healthy lateral, the filling time of capillary of the skin flap, the volume wave area of blood perfusion in replanted rabbit ear) and postoperation coagulation indexes (platelet count, fibrinogen, prothrombin time, activated partial prothrombin time) before treatment (T0), and 1-(T1), 12-(T2), 24-(T3), 48-(T4) hours after treatment were monitored. Results (1) The levels of adrenaline at different time point after treatment in two groups were all higher than those at T0 (all P<0.05), but the levels at different time point after treatment in group B were all lower than those in group A (all P<0.05). The levels of noradrenaline at different time point after treatment in two groups were all higher than those at T0, but there was no significant difference in two groups (all P>0.05).(2) Compared with group A, platelet count and fibrinogen decreased in group B(all P<0.05), and the prothrombin time and activated partial prothrombin time were all prolonged in group B(all P<0.05). (3) Compared with opposite side, the temperatures of replanted ears first rising at short time,then declining, and no large wave occurred after 12 hours in two groups. Mean temperature differences at different time point in group A were higher than those in group B (all P<0.05); compared with group B, the filling time of capillary at different time point in group A prolonged (all P<0.05); there were statistical differences in the area of SpO2 volume wave area at T1, T3 and T4 of two groups (all P<0.05). Conclusion Hemodilution could significantly improve blood circulation of replanted rabbit ears tissures.