Zhang Qing-fu, Bai Yong-qiang
Department of Burns and Plastic Surgery, the First Affiliated Hospital of Hebei Medical University, Shijiazhuang 050031, China.
Zhonghua Shao Shang Za Zhi. 2009 Oct;25(5):368-71.
To observe the changes in surface microcirculation of pancreas after high-voltage electric burn (HEB).
Thirty rabbits were divided into electrical injury (E) group and control (C) group in a simple random method, with 15 rabbits in each group. Rabbit model of HEB was reproduced from E group with TC-30-20KVA type voltage regulator and YDJ-10KVA type experimental transformer. Rabbits in C group were shamly burned with the same equipment as in E group but not electrified. Intravenous blood of rabbits in both groups was drawn 15 mins before HEB and 0, 1, 2, 4, 8 h after to determine the levels of serum amylase and blood glucose. The morphology of the pancreas microvessels and its surrounding tissues, and the dynamic changes in microvascular blood flow were observed with WX-9 microscope and its image analytical system.
The level of serum amylase of rabbits in E group increased gradually and peaked (849 +/- 39) U/L at 8 post HEB h (PHH), which decreased gradually reaching the nadir (153 +/- 21) U/L at 8 PHH in C group (P < 0.05). The blood glucose levels of rabbits in E group and C group increased gradually, with the former level obviously higher than the latter (P < 0.05). Arteriole, venule and capillary network on the surface of pancreatic lobules of rabbits in both groups were clearly seen and well-distributed in the natural way before HEB. In E group, arterioles of rabbits contracted at 0 PHH, and increased gradually in caliber size at 1 PHH; venules of rabbits were unevenly thickened at 2 PHH, and dilated at 8 PHH; the capillaries were contracted or with interrupted flow or completely obstructed at 0 PHH, and their thickness were uneven at 2 PHH, showing exudation at 8 PHH. There was no obvious change of microvessels in rabbits in C group at each time point. There was no exudation and bleeding around the microvessels on the pancreas surface of rabbits in both groups before HEB. In E group exudation was observed around microvessels at 1 PHH, bleeding was observed at 2 PHH and became obvious at 4 PHH; exudation and diffuse bleeding from capillaries were observed at 8 PHH. There was no exudation and bleeding in rabbits in C group as observed at each time point. Before HEB, blood flow speed in microvessels of rabbits in 2 groups was similar to each other (P > 0.05), and no erythrocyte aggregation or microthrombus was found in both groups. In E group, blood flow speed slowed down at 0 PHH as compared with that before HEB, it accelerated at 1 h and slowed down later; erythrocyte aggregation in venules and capillaries was found at 0 PHH, and it aggregated gradually. No above-mentioned change was found in C group.
HEB produces microcirculation disturbance and functional disturbance of pancreas.
观察高压电烧伤(HEB)后胰腺表面微循环的变化。
采用简单随机法将30只家兔分为电损伤(E)组和对照组(C)组,每组15只。用TC - 30 - 20KVA型调压器和YDJ - 10KVA型实验变压器对E组家兔复制HEB模型。C组家兔用与E组相同的设备进行假烧伤但不通电。两组家兔于HEB前15分钟及HEB后0、1、2、4、8小时采集静脉血,测定血清淀粉酶和血糖水平。用WX - 9显微镜及其图像分析系统观察胰腺微血管及其周围组织的形态以及微血管血流的动态变化。
E组家兔血清淀粉酶水平逐渐升高,在HEB后8小时(PHH)达到峰值(849±39)U/L,之后逐渐下降,C组在8 PHH时降至最低点(153±21)U/L(P < 0.05)。E组和C组家兔血糖水平均逐渐升高,前者明显高于后者(P < 0.05)。HEB前两组家兔胰腺小叶表面的小动脉、小静脉和毛细血管网清晰可见,分布自然。E组家兔小动脉在0 PHH时收缩,1 PHH时管径逐渐增大;小静脉在2 PHH时粗细不均,8 PHH时扩张;毛细血管在0 PHH时收缩或血流中断或完全阻塞,2 PHH时粗细不均,8 PHH时出现渗出。C组家兔在各时间点微血管无明显变化。HEB前两组家兔胰腺表面微血管周围均无渗出和出血。E组在1 PHH时微血管周围出现渗出,2 PHH时出现出血,4 PHH时出血明显;8 PHH时毛细血管出现渗出和弥漫性出血。C组家兔在各时间点均未观察到渗出和出血。HEB前两组家兔微血管血流速度相似(P > 0.05),两组均未发现红细胞聚集或微血栓形成。E组0 PHH时血流速度较HEB前减慢,1小时时加快,之后又减慢;0 PHH时在小静脉和毛细血管中发现红细胞聚集,且逐渐加重。C组未发现上述变化。
HEB可导致胰腺微循环障碍和功能紊乱。