不合理使用止血带加重切口感染及预处理的保护作用
作者:
作者单位:

作者简介:

周君琳

通讯作者:

中图分类号:

R619

基金项目:

北京市自然科学基金(7152061)


Irrational use of tourniquet aggravates incisional infection  and  protective effect of ischemic preconditioning
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 文章评论
    摘要:

    目的通过动物模型探讨止血带对切口感染的影响,以及探讨缺血预处理对切口感染的作用,为临床中合理使用止血带提供实验基础。方法100只BALB/c小鼠随机分为4组,每组25只小鼠,A组:止血带+切口耐甲氧西林金黄色葡萄球菌(MRSA)感染;B组:缺血预处理+切口MRSA感染;C组:切口MRSA感染;D组:空白对照。比较各组小鼠生存率、体温、血常规及股骨内侧切口周围软组织变化。结果观察期内A组小鼠生存率为68%,B、C、D组小鼠生存率均为100%。生存分析结果表明,A组小鼠生存率低于B、C、D组小鼠(P<0.05)。A、B、C组小鼠各个时间点体温比较,差异有统计学意义(P<0.01);4组小鼠体温曲线组间比较,差异有统计学意义(P<0.01);除基础体温外,其余时间点4组小鼠体温差异均有统计学意义(均P<0.01)。第3天、第7天4组小鼠血常规(白细胞总数、粒细胞总数、淋巴细胞总数)比较,差异均有统计学意义(均P<0.05)。第7 天4组小鼠血常规均恢复至正常范围内,但A组小鼠血常规各指标均相对于B、C、D组仍偏高。A组小鼠切片上皮组织均未愈合,周围组织炎症反应最重;B组小鼠切片中,10只上皮组织愈合,部分切片可见炎症反应;C组小鼠中,4只上皮组织愈合,大部分切片可见炎症反应。结论小鼠下肢应用止血带可加重切口感染程度,延缓切口愈合,延长机体恢复正常的时间,甚至导致死亡。制造切口模型前进行缺血预处理可减轻切口感染程度,缩短切口愈合时间。

    Abstract:

    ObjectiveTo evaluate the effect of  tourniquet on incisional  infection  based on animal model, and evaluate the effect of ischemia preconditioning on incisional  infection, so as to provide experimental basis for the rational use of tourniquet in clinic.Methods100 BALB/c mice were randomly divided into 4 groups, with 25 mice in each group. Group A: tourniquet+methicillinresistant Staphylococcus aureus(MRSA) incisional infection; group B: ischemic preconditioning+MRSA incisional infection ; group C : MRSA incisional infection; group D: blank control. The survival rates, temperature, routine blood testing, and change in soft tissue beside femoral incision were compared among 4 groups.ResultsDuring observation period ,the survival rate in group A was 68%, in group B,C, and D were all 100%,  group A was lower than group B,C, and D (P<0.05). The temperature at each time point was significantly different among group A, B, and C (P<0.01); temperature curves of 4 groups were significantly different (P<0.01); except basal body temperature, temperature at the other  time points among 4 groups were significantly  different(all P<0.01); routine blood testing results (white blood cell count, total granulocyte count, and total lymphocyte count) among 4 groups  on the third, and seventh day were significantly different(all P<0.05); on the seventh  day, routine blood testing results of 4 groups all returned to normal level, but group A was slightly higher than group B,C, and D. Section of epithelial tissue revealed that epithelial tissue in group A was not healed,inflammatory response of peripheral tissue was most serious;epithelial tissue in 10 mice in group B was healed,partial peripheral tissue revealed inflammatory response;epithelial tissue in 4 mice in group C was healed,most peripheral tissue revealed inflammatory response.ConclusionMice incisional infection will be aggravated by using lower limb tourniquet, incision healing and body function recovery time will be delayed, even lead to death. Ischemic preconditioning before making an incision model can reduce the severity of incisional infection, and shorten wound healing time.

    参考文献
    相似文献
引用本文

王东,单磊,周君琳.不合理使用止血带加重切口感染及预处理的保护作用[J]. 中国感染控制杂志,2015,14(11):730-734. DOI:10.3969/j. issn.1671-9638.2015.11.003.
WANG Dong, SHAN Lei, ZHOU Junlin. Irrational use of tourniquet aggravates incisional infection  and  protective effect of ischemic preconditioning[J]. Chin J Infect Control, 2015,14(11):730-734. DOI:10.3969/j. issn.1671-9638.2015.11.003.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2015-03-20
  • 最后修改日期:2015-06-12
  • 录用日期:
  • 在线发布日期: 2015-11-30
  • 出版日期: