局部皮肤持续受压致压疮的实验研究

Pressure Ulcer Induced by Sustained Local Skin Compression:A Study in Rats

目的通过局部皮肤持续压力动物模型,观察压力与时间对压疮发生的影响并探讨其机制。方法持续压迫大鼠腿及膝关节骨隆突处皮肤以建立压疮模型装置,并按不同压迫时间随机分为对照组(n=6,未受任何压力),局部压迫1 h组(n=9)2、h组(n=10)3、h组(n=10),以及压迫2 h缓解1 h组(n=12)、缓解2 h组(n=8)组,观察各组皮肤软组织的病理变化。结果对照组大鼠皮肤组织结构未发生变化;不同压迫时间组大鼠的皮肤组织变化有统计学差异(P<0.05);局部缓解组与持续压迫2 h组比较,差异无统计学意义(P>0.05)。结论随着压迫时间的延长,可以使皮肤软组织产生缺血、缺氧、坏死的变化,肌肉及脂肪组织比表皮对压力更敏感,反复短时间的局部压迫也可以加剧压疮发生的危险。

Objective To explore the relationship between the occurrence of pressure ulcer, and investigate the the duration of sustained local compression and mechanisms of compression-induced skin ulcer. Methods Sustained compression was applied on the skin of rat limbs and knee joint to induce skin ulcers. According to the duration and manner of compression, the rats were divided into the control group（ n = 6, without compression）, 1 h, 2 h and 3 h local compression groups（ n = 9, 10, respectively）, and 1 and 2 h after a 2-h compression groups （ n=12 andn =8）. The soft tissues at the compression were sampled for pathological examination. Results In the control group, no pathological changes were found in the skin tissues. Different durations of local compression induced significantly different pathological changes in the skin（ P 〈0.05）, and after a 2-h compression, relief of the pressure did not reverse the pathological changes（ P〉 0.05）. Conclusion Prolonged compression induces ischemia, hypoxia, and ultimately necrosis of the local dermal soft tissues. The muscular and fat tissues are more vulnerable than the epidermis to compression, and repeated compression even of short duration also increases the risks of pressure ulcer.