创伤后兔肢体深静脉血栓形成的影响因素

Influencing factors related to deep venous thrombosis in limbs of post-trauma rabbits

目的:在已有的创伤性肢体深静脉血栓(deepvenousthrombosis,DVT)动物模型的基础上,探索创伤后兔肢体深静脉血栓形成的影响因素。方法:实验于2004-03/11在昆明医学院外总教研室进行。80只新西兰大白兔随机分成骨折、创伤、固定和空白4组,造模前用高频彩色超声机观测左下肢伸直位和屈髋屈膝位时股静脉血流速度和血管内径变化,造模后第7天分别行光学显微镜和透射电子显微镜观测血栓、静脉内皮和内膜变化,所得数据进行统计学处理。结果:①DVT发生率骨折组为78,95%与创伤组80.00%比较差异无显著性意义(P>0.05),但与固定组(30.00%)和空白组(0)差异有非常显著性意义(P<0.01);固定组与空白组DVT发生率差异有显著性意义(P<0.05)。②光镜与电镜检查显示骨折组、创伤组静脉内皮和内膜受损程度较固定组严重,固定组又较空白组严重;血栓栓塞部位均可见炎性细胞浸润。③彩超显示左下肢伸直位时血流量为(0.0637±0.0152)cm3/s,屈髋屈膝位时为(0.0229±0.0107)cm3/s;左下肢伸直位时血管内径为(0.16±0.04)cm,屈髋屈膝位时血管内径为(0.10±0.04)cm,差异具有显著性意义(P<0.01)。④Logistic回归OR创伤=6.000。结论:创伤、固定和体位在兔创伤性肢体DVT的发生过程中均起重要作用,创伤因素尤为关键;炎症与DVT有一定关系,但这?

AIM:To investigate the influencing factors on rabbit model of traumatic deep venous thrombosis(DVT) in limbs based on the established animal model of traumatic DVT in limbs of rabbits.METHODS:The experiment was conducted in the General Department of Surgery,Kunming Medical College from March to November 2004.Eighty New Zealand white rabbits were divided randomly into 4 groups:fracture,trauma,fixation and blank groups.The blood flow rate of femoral veins and the inner diameter of blood vessel were examined by high frequency color Doppler ultrasound when the joint of left knee straightened and hip flexed in flexible position before the model was made.The changes of venous thrombosis,endothelium and endometrium were examined with histological examination 7 days after the modeling.The data obtained were managed statistically.RESULTS:① The incidence of DVT of fracture group(78.95% ) was insignificantly different from that of trauma group(80.00% )(P >0.05),while that of fixation group(30.00% ) was significantly different from that of blank group(0)(P< 0.05).② The results of light and electron microscope showed that the damage of venous endothelium and endometrium of fracture and trauma groups were worse than those of fixation group,and those of the fixation group was worse than those of blank group.Infiltration of inflammatory cells was observed at thrombo embolism.③ It was shown from color Doppler ultrasound,the blood flow rate of rabbits was (0.063 7± 0.015 2) cm3/s when left lower limbs were straightened and (0.022 9± 0.010 7) cm3/s when hip and thigh fixed in flexible position.The inner diameter of blood vessel was (0.16± 0.04) cm when left lower limbs were straightened and (0.10 ± 0.04) cm when hip and thigh fixed in flexible position,with significant difference between them(P< 0.01).④ The ORtrauma was 6.000 for Logistic regression.CONCLUSION:Trauma,fixation and body position are important in the development of rabbit traumatic DVT,and trauma is the most important factor.There is a certain relationship between inflammation and DVT,and the inflammatory reaction may be caused not only by trauma.