温度对家兔微血管术后血液循环影响的实验研究

An experimental study on influence of temperature on postoperative blood supplying of rabbits after underwent microvascular operation

[目的]通过Na99mTcO4示踪显像(TTI)探讨温度对家兔微血管术后血液循环的影响。[方法]将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(20℃～25℃)中30min,由耳缘静脉注射Na99mTcO474MBq1min后行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级、Ⅰ级、Ⅱ级。将Ⅰ级、Ⅱ级家兔随机分为A组、B组、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后再次行TTI。[结果]30只术后家兔TTI为0级、Ⅰ级、Ⅱ级分别有6只、15只、9只,6只对照均为Ⅱ级,4组T/NT分别为0.589±0.074、0.602±0.092、0.594±0.068、0.128±0.058,A组、B组、C组间无差异(P>0.05),均明显高于D组(P<0.01);经不同方法处理后A、B、C、D组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);各组与首次TTI均有显著差异(P<0.01)。[结论]温度为微血管术后血液循环的重要影响因素,术中、术后积极的保暖对预防微血管术后血管危象具有重要的临床价值。

Objective: To probe into the influence of temperature on blood supply of rabbit after microvascular operation through Na 99m TcO4 technetium tagging imaging (TTI). Method: A total of 30 healthy adult rabbits underwent hind limb replantation were selected in test group and 6 normal rabbits were taken as control and put them under room temperature(20 ℃～25 ℃) for half an hour. Then TTI were performed one minute after Na  99m TcO4 74 MBq injecting via ear fringe vein for all subjects. The ratio of radioactivity uptake (T/NT) between the limb replantation and normal limb of rabbits were calculated and analyzed. According to the outcomes of radioactive accumulation of the limb, subjects in test group were divided into grade 0, Ⅰ, andⅡ. The rabbits of the gradeⅠand Ⅱwere further divided into group A, B, and C randomly. Rabbits of grade 0 were in D group. Rabbits of group A were given local cold application (<10 ℃). Rabbits of group B and group D were given local hot(40 ℃～45 ℃)application. Rabbits of group C were put under room temperature continuously. TTI were repeated for all subjects 30 min later. Result: There were 6, 15 and 9 rabbits in grade 0, ⅠandⅡ respectively based on TTI of 30 test group rabbits after operation. And 6 rabbits of control group were in gradeⅡ. The radio of T/NT were 0.589±0.074, 0.602±0.092, 0.594±0.068, 0.128±0.058 in the four groups respectively. There were no statistical differences among subjects of group A, B and C (P>0.05). However,the radios of T/NT of subjects of group A, B and C were higher than that in group D(P<0.01). After different treatment, the radios of T/NT in group A, B, C and D were 0.192±0.086, 0.924±0.168, 0.481±0.116,0.372±0.124 respectively. Group A was at the lowest and group B was at the highest. The radios of T/NT of all groups after treatment were higher than that of before (P<0.01). Conclusion: It showed that the temperature is an important factor influencing postoperative microvascular blood supply. During and after operation, to keep temperature stable actively has an important clinical value on prevention of postoperative blood vessel articulo.