Revell W J, Brookes M
Academic Department of Orthopaedics, Rayne Institute, St. Thomas' Hospital, London, UK.
J Anat. 1994 Jun;184 ( Pt 3)(Pt 3):625-33.
Interference with venous outflow from a limb to stimulate fracture repair and bone growth has a long history, and its beneficial effects have been confirmed by many experimental and clinical studies. With the development of fracture fixation systems, the therapeutic use of circulatory intervention became redundant. Recently, a venous tourniquet effect has been cited to explain the enhancement of bone healing observed after fracture fixation with the Aircast system. As bone appears to be altered by venous stasis, it is important to characterise the vascular perturbations leading to these changes. Previous studies have often given conflicting results. This study investigated the short and long term haemodynamic effects of femoral vein ligation. Changes in blood flow rate and blood volume in the distal femur and proximal tibia of the rat were examined at 6 h and 1, 3 and 7 d following unilateral femoral vein ligation, and at 8 and 16 wk. Blood flows and volumes were generally reduced in the ligated limb 6 h after femoral vein ligation. This initial depression was followed by a relative increase (comparing the ligated limb with the contralateral unoperated bone) in blood volume during the 1st week. A significant relative reduction in epiphyseal vascular space was observed after 16 wk. A sustained reduction of arterial input to whole femora and tibiae was present in the ligated limb throughout the investigation although, for the cancellous knee joint epiphysis of the tibia, a localised relative increase in flow was apparent during the 1st week, again comparing the ligated limb with the nonligated contralateral bone.(ABSTRACT TRUNCATED AT 250 WORDS)
通过干扰肢体静脉流出以刺激骨折修复和骨骼生长已有很长历史,其有益效果已得到许多实验和临床研究的证实。随着骨折固定系统的发展,循环干预的治疗用途变得多余。最近,有人引用静脉止血带效应来解释使用Aircast系统固定骨折后观察到的骨愈合增强现象。由于骨骼似乎会因静脉淤滞而发生改变,因此明确导致这些变化的血管扰动很重要。先前的研究结果常常相互矛盾。本研究调查了股静脉结扎的短期和长期血流动力学效应。在单侧股静脉结扎后的6小时、1天、3天和7天以及8周和16周时,检测大鼠股骨远端和胫骨近端的血流速度和血容量变化。股静脉结扎后6小时,结扎肢体的血流和血容量通常会降低。在第1周期间,这种最初的降低之后是血容量的相对增加(将结扎肢体与对侧未手术的骨骼进行比较)。16周后观察到骨骺血管间隙有明显的相对减小。在整个研究过程中,结扎肢体的股骨和胫骨的动脉输入持续减少,不过,对于胫骨的松质膝关节骨骺,在第1周期间,与未结扎的对侧骨骼相比,局部血流相对增加明显。(摘要截断于250字)