高压电烧伤家兔胰腺微循环的变化

Dynamic change in microcirculation of pancreas after experimental high-voltage electric burn

目的了解家兔高压电烧伤后胰腺微循环的变化情况。方法将30只家兔采用简单随机法分为电伤组和对照组，每组15只。电伤组家兔用调压器和实验变压器制成高压电烧伤模型，对照组家兔接相同装置但不通电，致假伤。于伤前15min及伤后0、1、2、4、8h抽取2组家兔静脉血，检测其血清淀粉酶和血糖水平。同时用微循环显微镜及其图像分析系统，检测胰腺微血管形态、周围状态以及微血流变化。结果（1）电伤组家兔伤后血清淀粉酶逐渐升高，至伤后8h[（849±39）U／L]达高峰，而对照组却逐渐下降，伤后8h至最低[（153±21）U／L，P〈0．05]。2组家兔伤后血糖均逐渐升高，但电伤组却明显高于对照组（P〈0．05）。（2）2组家兔伤前胰腺小叶表面的微动脉、微静脉及毛细血管网清晰可见，走行自然，分布均匀。电伤组微动脉伤后0h收缩，伤后1h起管径逐渐增加；微静脉伤后2h出现粗细不均现象，伤后8h扩张；毛细血管伤后0h收缩、断流或完全闭塞隐没，伤后2h粗细不均，伤后8h管径变小。对照组各时相点微血管形态无明显变化。（3）2组家兔伤前胰腺表面微血管周围未见渗出和出血。电伤组伤后1h微血管周围有渗出，伤后2h开始微血管周围有出血现象，伤后4h出血明显，伤后8h见毛细血管渗出和片状出血。对照组伤后各时相点微血管周围无明显变化。（4）2组家兔伤前胰腺表面微血管内血流速度接近（P〉0．05），均未见红细胞聚集和微血栓。电伤组伤后0h微血管血流速度较伤前减慢，1h时有所恢复，随后又减慢；伤后0h起微静脉和毛细血管出现红细胞聚集并逐渐加重。对照组无上述变化。结论高压电烧伤会导致胰腺微循环及功能障碍。

Objective To observe the changes in surface microcirculation of pancreas after highvoltage electric burn （HEB）. Methods Thirty rabbits were divided into electrical injury （E） group and control （C） group in a simple random method, with 15 rabbits in each group. Rabbit model of HEB was reproduced from E group with TC-30-20KVA type voltage regulator and YDJ-10KVA type experimental transformer. Rabbits in C group were shamly burned with the same equipment as in E group but not electrified. Intravenous blood of rabbits in both groups was drawn 15 mins before HEB and O, 1 , 2, 4, 8 h after to determine the levels of serum amylase and blood glucose. The morphology of the pancreas microvessels and its surrounding tissues, and the dynamic changes in microvascular blood flow were observed with WX-9 microscope and its image analytical system. Results The level of serum amylase of rabbits in E group increased gradually and peaked （849 ± 39）U/L at 8 post HEB h （PHH） , which decreased gradually reaching the nadir （153±21） U/L at 8 PHH in C group （ P 〈0.05）. The blood glucose levels of rabbits in E group and C group increased gradually, with the former level obviously higher than the latter （ P 〈 0. 05 ）. Arteriole, venule and capillary network on the surface of pancreatic lobules of rabbits in both groups were clearly seen and well-distributed in the natural way before HEB. In E group, arterioles of rabbits contracted at 0 PHH, and increased gradually in caliber size at 1 PHH ; venules of rabbits were unevenly thickened at 2 PHH, and dilated at 8 PHH ; the capillaries were contracted or with interrupted flow or completely obstructed at 0 PHH, and their thickness were uneven at 2 PHH, showing exudation at 8 PHH. There was no obvious change of microvessels in rabbits in C group at each time point. There was no exudation and bleeding around the microvessels on the pancreas surface of rabbits in both groups before HEB. In E group exudation was observed around microvessels at 1 PHH, bleeding was observed at 2 PHH and became obvious at 4 PHH ; exudation and diffuse bleeding from capillaries were observed at 8 PHH. There was no exudation and bleeding in rabbits in C group as observed at each time point. Before HEB, blood flow speed in microvessels of rabbits in 2 groups was similar to each other （ P 〉 0.05 ）, and no erythrocte aggregation or microthrombus was found in both groups. In E group, blood flow speed slowed down at 0 PHH as compared with that before HEB, it accelerated at 1 h and slowed down later; erythrocyte aggregation in venules and cappillaries was found at 0 PHH, and it aggregated gradually. No above-mentioned change was found in C group. Conclusions HEB produces microcirculation disturbance and functional disturbance of pancreas.