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目的:术后患肢的固定可削弱肌肉泵的作用,造成静脉血流缓滞,增加深静脉血栓形成的风险。通过对兔下肢行伸直位和屈髋屈膝位固定探讨其对兔股静脉血栓形成的影响。方法:实验于2003-10/2004-03在昆明医学院外科总论实验室和第一附属医院超声科完成。健康成年新西兰白兔60只,体质量(3.0±0.2)kg,雌雄不限。先行预实验,随机抽取12只,行耳缘静脉麻醉后人工固定兔左下肢伸直位与屈髋屈膝位(模拟石膏外固定),应用高频彩色多普勒血流显像仪观测,结果显示兔左下肢屈髋屈膝位可以引起血流速度减慢,血管内径变小,血流量降低。再将60只新西兰白兔随机分为两组,①固定组(n=30),行左下肢于屈髋屈膝位石膏外固定。②空白对照组(n=30),不作任何处理。于固定后5,7,9d两组动物行组织学观察,各时相点动物均为10只。主要观察:①高频彩色多普勒血流显像仪观测兔左下肢伸直位和屈髋屈膝位股静脉的血流速度和血管内径。②组织学观察两组兔左股静脉血栓发生情况。结果:纳入60只兔均进入结果分析。①固定为左下肢伸直位兔左股静脉的血流量为(0.064±0.015)cm3/s,左下肢固定为屈髋屈膝位时左股静脉血流量为(0.023±0.010)cm3/s,屈髋屈膝位较伸直位时血流速度减慢,血管内径变小,血流量降低(t=8.106,P<0.01)。②固定组5,7,9d左股静脉血栓发生率分别为20%,30%和10%;空白对照组均为0。固定组血栓发生率显著高于空白对照组(P<0.05)。结论:兔下肢在屈髋屈膝位时血流速度减慢,血管内径变小,血流量较伸直位时明显降低,更容易导致肢体深静脉血栓形成。
OBJECTIVE: Postoperative limb immobilization weakens the role of the muscle pump, causing a slowed venous flow and increasing the risk of deep venous thrombosis. To investigate the effect of extensor vertebrae in lower extremities and hip flexion of hip flexion on the thrombosis of rabbit femoral vein. Methods: The experiment was performed in the Department of Ultrasound, the General Surgery Laboratory and the First Affiliated Hospital of Kunming Medical College from October 2003 to March 2004. 60 healthy New Zealand white rabbits, body weight (3.0 ± 0.2) kg, male or female. First pre-experiment, a random sample of 12, after the limbal vein anesthesia artificially fixed rabbit left lower extremity extension and flexor knees knees (simulated gypsum external fixation), the application of high-frequency color Doppler flow imaging was observed, the results Showing the left lower limb flexion and flexion of the knees can cause slow blood flow, vascular diameter smaller, lower blood flow. Sixty New Zealand white rabbits were randomly divided into two groups. ① Fixed group (n = 30). ② blank control group (n = 30), without any treatment. At 5, 7 and 9 days after fixation, the animals in each group were observed histologically, and 10 animals were taken at each time point. MAIN OUTCOME MEASURES: ① The high-frequency color Doppler flow imaging instrument was used to observe the extensional position of the left lower extremity and the blood flow velocity and vessel diameter of the hip of the hip flexor. ② histological observation of two rabbits left venous thrombosis occurred. Results: 60 rabbits were included in the result analysis. ① The blood flow of the left femoral vein fixed to the left lower extremity was (0.064 ± 0.015) cm3 / s and that of the left lower extremity fixed to the knee was (0.023 ± 0.010) cm3 / s Hip flexion position more straightened when the blood flow slowed down, vascular diameter smaller, lower blood flow (t = 8.106, P <0.01). ② The incidence of left femoral vein thrombosis in fixed group was 20%, 30% and 10% at 5, 7 and 9 days respectively; The incidence of thrombosis in the fixed group was significantly higher than that in the blank control group (P <0.05). CONCLUSION: The blood flow velocity of the lower extremities in flexing knees is slowed while the inner diameter of blood vessels is reduced. The blood flow is significantly lower than that in the extension position, which is more likely to lead to deep vein thrombosis.