不同压力作用形式对大鼠压疮缺血再灌注损伤的影响

Effects of Different Pressure Forms on Pressure Ulcer Ischemia-reperfusion Injury

目的探讨不同压力作用形式(垂直压力、摩擦力和剪切力)对压疮的影响,为其纳入压疮危险因素评估表并给予相应分值提供实验依据。方法将32只远交群大鼠(sprague dawley,SD)按随机数字表法分为4组:对照组(A组)、垂直压力组(B组)、摩擦力组(C组)和剪切力组(D组),建立大鼠压疮缺血再灌注模型。肉眼观察大鼠受压部位皮肤完整性和颜色变化,测定血清中超氧化物歧化酶(SOD)的活性、丙二醛(MDA)和一氧化氮(NO)的含量,并在光镜下对受压部位的表皮及肌肉组织进行观察。结果除对照组外,肉眼及光镜观察其他3组大鼠的受压部位均出现损伤,其中剪切力组肌肉损伤比垂直压力组更明显;摩擦力组表皮损伤比垂直压力组更明显。摩擦力组和剪切力组血清SOD和NO含量下降,MDA含量增加,与对照组及垂直压力组比较差异均有统计学意义(P<0.05或P<0.01)。结论垂直压力、摩擦力和剪切力可以纳入压疮危险因素评估表且分值依次递增。

Objective To discuss the effects of different pressure forms （vertical pressure, friction and shear force）on pressure ulcers, so as to integrate them into pressure ulcer risk factors assessment scale and give corresponding theoretical basis for the score. Methods Thirty-two SD rats were randomly divided into four groups：control group （group A）, vertical pressure group （group B）,friction group （group C） and shear force group（group D）. Then a rat pressure ulcer ischemia-reperfusion model was established. Macro- scopic observation was conducted on rat skin integrity and color changes of pressure parts, which was fol- lowed by determination of serum superoxide dismutase（SOD） activity,malondialdehyde （MDA） and nitric oxide （NO） content and the epidermis,dermis and muscle tissue. Results Except the control group,injuries were detected of the pressure areas of the other three groups by the naked eye and microscopic obser- vation. Muscle damage in the shear force group was more significant than that in the vertical pressure group;skin damage in the friction group was more significant than that in the vertical pressure group. The levels of SOD and NO significantly decreased and the level of MDA significantly increased in the friction group and shear force group, compared with the control group and vertical pressure group（P〈0.01 or P〈 0.05）. Conclusion The vertical pressure,friction and shear force can be integrated into pressure ulcer risk factors assessment scale, with progressive scale scores.