Na^(99m)TcO_4示踪温度对微血管术后血供影响的实验研究

Experimental Study on Effect of the Blood Supply for Temperature in Rabbits After Microvascular Surgery by Na^(99m)TcO_4 Trace Imaging and it's Nursing Strategy.

目的通过 Na^(99m)TcO_4示踪显像(TTI)探讨温度对家兔微血管术后血供的影响。方法后肢施行断肢再植术的30只健康成年家兔和6只正常对照家兔置于室温中30min,由耳缘静脉注射 Na^(99m)TcO_4 74MBq 1min 后 TTI,计算并分析再植部分和正常肢对应部分的放射性摄取比值(T/NT)。根据术肢放射性聚集程度将显像结果分为0、Ⅰ、Ⅱ三级(T/NT 分别为<0.25,0.25～0.65,>0.65)。将Ⅰ、Ⅱ级家兔随机平分为 A、B、C 组,0级为 D 组;A 组在伤口局部冷敷(<10℃)、B 组和 D组局部热敷(40～45℃)、C 组继续置于室温;30min 后再次 TTI。结果①30只术后家兔 TTI 为0、Ⅰ、Ⅱ级分别有6、15、9只,6只对照全为Ⅱ级,四组的 T/NT 分别为0.589±0.074、0.602±0.092、0.594±0.068、0.128±0.058,A、B、C 三组间无显著性差异(P>0.05),均明显高于 D 组(P<0.01);②再次 TTI,四组的 T/NT 分别为0.192±0.086、0.924±0.168、0.481±0.116、0.372±0.124;A 组最低(P<0.01),B 组最高(P<0.01),C、D 组间无显著性差异(P>0.05);各组与首次 TTI 均有显著性差异(P<0.01)。结论温度为微血管术后血供的重要影响因素,保暖对防治微血管术血管危象具有重要的临床意义。

Objective To evaluate the effect of the blood supply for temperature in rabbits after microvascular surgery by Na ^(99m)TcO4 trace imaging(TTI). Methods 30 healthy adult rabbits with replanted limb and 6 normal rabbits were put on common temperature 30 minutes.Then, TTI was performed on each of rabbits. The radionuclide uptake of replanted limb/normal limb ratio(T/NT)was analyzed using region of interest analysis.0, Ⅰ and Ⅱ scales were classified according to thier radionuclide distribution and T/NT(<0.25, 0.25～0.65, >0.65, respectve- ly). The rabbits of Ⅰ and Ⅱ scales were average divided A, B and C groups. The 0 scales was D groups. Localy frezzing(<10℃)was given in A groups. Localy warming(40～45℃)were given in B and D groups. C groups were put on common temperature continuously. All rabbits per- formed an TTI again in 30 minutes. Results ①0, Ⅰ and Ⅱ scales of first TTI were 6, 15 and 9 rabbits after microvascular surgery, respectve- ly. All normal rabbits were Ⅱscales. The T/NT of A, B, C and D groups were 0.589±0.074, 0.602±0.092, 0.594±0.068 and 0.128± 0.058, respectively.There were no significant difference among A, B and C groups(P>0.05), significantly higher than D groups(P< 0.01), respectively.②The T/NT of second TTI in A, B, C and D groups were 0.192±0.086, 0.924±0.168, 0.481±0.116 and 0.372± 0.124, respectively. The T/NT of A groups was most lowest(P<0.01), B groups was most highest(P<0.01), no significant difference between C and D groups(P>0.05). All groups were significant difference between first and second TTI(P<0.01). Conclusion Temperature is an important related factor of the blood supply after microvascular surgery. Warming actively could play an important role on treating and pre- venting the vascular crisis in patients with microvascular surgery.