标题：被冰水浸泡后大鼠断肢再植的实验研究

      作者：周健辉，李秀文，王夫平，冷树立
    (南方医科大学附属小榄医院手外科，广东 中山 528415)

      卷次： 2014年25卷3期

      【摘要】 目的 研究被冰水浸泡大腿断肢后的不同时段对血管损伤程度的影响，为被冰水浸泡的断指再植
病例提供科学理论支持。方法 实验选用成年大鼠共20只，雌雄不限，随机分为4组，分别把左侧大腿中上1/3
水平环形离断，然后分别将断肢冰水浸泡1 h、2 h、4 h、6 h。然后对每组断肢血管进行病理观察，再将不同组织别
断肢进行再植，术中观察血管通血情况，通血0.5 h后均将血管切断，再次对断肢血管行病理分析，最后再次接通
断肢血运，缝合皮肤，把小鼠送回试验室，观察各组断肢再植的成活率。结果 血管内皮细胞在冻伤后的 1 h、
2 h、4 h内未见明显损伤，但在通过恢复血流复温后，内皮细胞就会产生不同程度的损伤。在 1 h组及 2 h组中，
断指再植的成活率较高，在 4 h组断肢再植成活率低，在 6 h组中，无一断肢成活。结论 被冰水浸泡后的血管
损伤程度随着时间的推移而加重，浸泡的时间越长，复位后血管形成的血栓越容易，当到达 6 h以上均形成不
可逆性损伤。

      【关键词】 冰水浸泡；断肢；再植；血管损伤

      【中图分类号】 R-332 【文献标识码】 A 【文章编号】 1003—6350（2014）03—0317—03


Experimental study of rat limb replantation of ice water immersion.
ZHOU Jian-hui, LI Xiu-wen, WANG
Fu-ping, LENG Shu-li. Department of Hand Surgery, Xiaolan People's Hospital Affiliated to Southern Medical University,
Zhongshan 528415, Guangdong, CHINA

【Abstract】 Objective To study the effect of different periods of ice water immersion on the vessel injury de-
gree, and to provide scientific theoretical support for rat limb replantation of ice water immersion. Methods Twenty
adult rats, regardless of gender, were selected and randomly divided into four groups, which were soaked in ice water
for 1 hour, 2 hours, 4 hours, 6 hours after the left leg in 1/3 horizontal ring off, respectively. Then pathological analysis
was performed on each limb vessel, then the limb was replanted. The blood flow was observed, and the vessel was cut
off again after half an hour. Based on pathological analysis, the limb blood circulation was restored and the skin was
sutured. Then the rats were sent back to laboratory to observe the survival rate of limb replantation. Results Vascular
endothelial cells were found no obvious damage after 1 h, 2 h, 4 h of ice water immersion, but showed different de-
grees of damage after rewarming by the restoration of blood flow. The survival rate of replantation was relatively high-