硅胶管重建对电击伤后肢体主干血管的影响

An Experimental Study on Major Blood Vessels of Rebuilt Limbs With Silicone Tube After Being Injured by Electric

目的用特制的硅胶管将电击伤肢体的伤区远近两端主干血管插管桥接,和用轴型皮瓣转移覆盖创面,以降低肢体电击伤截肢率。方法以40只健康成年犬为实验动物,电击伤后肢后分为实验组和对照组各20例。实验组:清除坏死变性组织,栓塞的动静脉切除,特制硅胶管插管至血管远近端的正常区,腹股沟皮瓣转移覆盖创面。对照组:保留栓塞的动静脉,腹股沟皮瓣转移覆盖创面。术后通过观察皮肤的成活面积,组织HE染色,静脉造影及肢体切开直视,从组织解剖学、形态学、影像学上初步探讨硅胶管重建受损血管对肢体电击伤后可能的影响机制。结果术后7天,对照组皮瓣成活率为25.18%±6.03%,实验组为89.16%±5.08%,两组比较,差异有统计学意义(P<0.05)。术后14天股动、静脉通畅情况,实验组(通畅10只)明显高于对照组(通畅1只)(P<0.05)。结论肢体电击伤后,用特制的硅胶管对伤区远近两端主干血管插管桥接,能降低肢体电击伤后的截肢率。

Objective After limb＇ s burn,the major blood vessels at the two ends of wound sections are intubatedly bridged with tailor - made silicone tube and axial pattern shin flap to transfer or cover the burnt section, to lower the rate of cutting the limbs. Methods 40 healthy dogs were divided equally into the experimental group and the control group. The experimental group： clearing the necrotic and metamorphic tissue, cutting the embolized arteries and veins, intubating the outlying and near working sections with specially - made silicone tube, making blood vessel web beneath the eutis at the outlying inguinal flap. The control group ： maitaining the embolized arteries and veins, making blood vessed web beneath the cutis at the outlying inguinal falp. After the operation the pathology of the limbs of each group have been changed by dyeing HE and observing the survived areas of different limb＇ s skin, the uhrastructure of limb tissue by transmission electric lens. The potentiality is to probe into the possible effective regime of rebuilding injured blood vessels after getting electrical shock with silicone tube. Results It was discovered that there was significant difference between the two groups by observing the survival situation of the outlying skin of each group＇ s limbs in 7 and 10 days （P 〈0.05 ）. After 14 days,the experi- mental team is clearly higher than control one in terms of observing the situation of thigh action and fluency of arteries based. The difference between groups is distinguished （ P 〈 0.05 ）. Conclusions The rate of cutting limbs could be reduced with tailor - made sihcone tube by intubating the major blood vessels of outlying and near wound sections at two ends after the limb had been electrically injured.