| 张淦,刘胜杰,王智,等.高压氧治疗海水浸泡火器伤兔股骨骨缺损的疗效观察[J].安徽医药,2023,27(5):999-1002. |
| 高压氧治疗海水浸泡火器伤兔股骨骨缺损的疗效观察 |
| Effect of hyperbaric oxygen on the open bone defect of limbs caused by firearm wound in seawater |
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| DOI：10.3969/j.issn.1009-6469.2023.05.034 |
| 中文关键词: 高压氧 创伤，枪击 海水浸泡 兔股骨骨缺损 火器伤 |
| 英文关键词: Hyperbaric oxygenation Wounds,gunshot Seawater immersion Bone defect of rabbit femur Firearm injury |
| 基金项目:军队后勤科研项目( CLB18J059) |
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| 中文摘要: |
| 目的观察高压氧治疗海水浸泡火器伤所致兔股骨开放性骨缺损的疗效。方法实验实施时间 2020年 7月至 2021年 5月。 84只新西兰兔采用随机数字表法分成对照组和高压氧组。制作海水浸泡火器伤所致肢体开放性骨缺损模型，对照组彻底清创后，行骨折切开复位钢板内固定术；高压氧组彻底清创后，行骨折切开复位钢板内固定术，连续高压氧治疗 7d。通过 X线摄片、定量 PCR法、 HE染色及生物力学分析评价各组治疗效果。结果血管内皮生长因子( VEGF)mRNA各组各个时间段均有表达，与对照组相比，高压氧组术后 1d［(2.97±0.25)比( 2.39±0.24)］、 3d［( 4.12±0.38)比( 3.65±0.30)］、 1周［(4.83±0.23)比( 4.36±0.39)］、 2周［(5.89±0.40)比( 5.04±0.36)］、 4周［(4.21±0.42)比( 5.04±0.36)］差异有统计学意义( P<0.05)；术后 8周、 12周，两组 VEGF mRNA表达，差异无统计学意义(P>0.05)。影像学观察:术后 2周两组未，见明显骨组织影，钢板及螺钉在位。术 |
| 英文摘要: |
| Objective To observe the effect of hyperbaric oxygen on the open bone defect of limbs caused by firearm wound in sea-water. Methods The experiment was performed from July 2020 to May 2021. Eighty-four New Zealand rabbits were randomly as-signed into control group and hyperbaric oxygen group. The model of the open bone defect of limbs caused by firearm wound in seawa-ter was made. After thorough debridement, open reduction of fracture was performed with plate internal fixation in control group, whileopen reduction, internal fixation and continuous hyperbaric oxygen treatment for 7 days were performed in hyperbaric oxygen group. X-ray radiography, quantitative PCR, HE staining and biomechanical analysis were used to evaluate the therapeutic effect of each group.Results Vascular endothelial growth factor (VEGF) mRNA was expressed in each group at all time periods. There were statisticallysignificant differences between control group and hyperbaric oxygen group at postoperative 1 d [(2.97±0.25) vs. (2.39±0.24)], 3 d [(4.12± 0.38) vs. (3.65±0.30)],1 week [(4.83±0.23) vs. (4.36±0.39)], 2 weeks [(5.89±0.40) vs. (5.04±0.36)],4 weeks [(4.21±0.42) vs. (5.04±0.36)] (P<0.05); There was no significant difference in VEGF mRNA expression between the two groups at 8 weeks and 12 weeks postopera-tively (P>0.05).Imaging observation results showed that two weeks after surgery, no obvious bone shadow was found in both groups, andplates and screws were present. Four weeks after surgery, thin cloud-shaped callus shadows were found in the bone defect area of con-trol group and hyperbaric oxygen group, and the shadow area of control group was bigger than that of hyperbaric oxygen group, platesand screws in position. Eight weeks after the operation, the bone shadow of control group was enhanced, and the bone healing of hyper-baric oxygen group was achieved. The medullary cavity was not completely recanalized, and the plates and screws were in place.Twelve weeks after operation, osseous union was achieved in control group, the medullary cavity was partially recanalized, and the plates and screws were in place. In hyperbaric oxygen group, the cortical continuity was good, the medullary cavity was recanted, the re-pair was basically completed, and the plates and screws were in place. Significant differences were found between control group and hy-perbaric oxygen group in Lane-Sandhu radiological score at postoperative 4 weeks [(4.17±0.75) vs. (2.83±0.98)],8 weeks [(7.67±1.63) vs. (5.67±0.82)],12 weeks [(10.17±1.47) vs. (7.83±1.17)](P<0.05);Lane-sandhu radiological scores at 2 weeks after surgery showed no significant difference between the two groups (P>0.05).Histological observation results showed that at the 12th week after surgery,largeamounts of lamellar bone formed in both groups, and the medullary cavity was partially recanalized in control group and recanalized inhyperbaric oxygen group,respectively. Biomechanical analysis results showed that maximum load [(195.97±11.70)N] in control groupwas lower than the maximum load[(239.75±10.76)N] in hyperbaric oxygen group,and the difference was statistically significant(P<0.05). Conclusion Hyperbaric oxygen therapy promotes the healing of the open bone defect of limbs caused by firearm wound in seawater. |
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