Ho S S, Coel M N, Kagawa R, Richardson A B
University of Hawaii, Division of Orthopaedic Surgery, Honolulu.
Am J Sports Med. 1994 Jul-Aug;22(4):537-40. doi: 10.1177/036354659402200417.
The effects of an ice wrap, applied to a knee for 20 minutes, on blood flow and bone metabolism were measured using triple-phase technetium bone scans. Twenty-one subjects between 29 and 63 years of age were studied. A commercially available ice wrap was applied to one knee 20 minutes before scanning, while an identical wrap left at room temperature was applied to the opposite knee to act as a control. Scans of the knees were obtained at the completion of cooling, and the images were quantified by computer image analysis for each knee at each phase of the scan. Percentage of decrease in blood flow and subsequent bone uptake of technetium for the iced knee as compared with the opposite knee were calculated. All iced knees demonstrated decreased arterial and soft tissue blood flow as well as decreased bone uptake, which is a reflection of changes in both bone blood flow and metabolism. The average decrease was 38.4% +/- 4.97 in arterial blood flow, 25.8% +/- 2.04 in soft tissue blood flow, and 19.3% +/- 2.0 (standard error of the mean in each) in bone uptake. This "ice effect" was not related to age, sex, knee circumference, or skin temperature after cooling. By decreasing blood flow and cell metabolism, ice theoretically can limit hemorrhage and cell death in the setting of acute traumatic injury. This study thus provides a scientific rationale for the use of ice as tested for such injuries to a large joint, whether in the soft tissues or bones.
使用三相锝骨扫描测量冰敷膝盖20分钟对血流和骨代谢的影响。研究了21名年龄在29至63岁之间的受试者。在扫描前20分钟，将市售冰敷袋敷于一侧膝盖，而将置于室温的相同冰敷袋敷于对侧膝盖作为对照。在冰敷结束时获取膝盖的扫描图像，并通过计算机图像分析对扫描各阶段的每个膝盖图像进行量化。计算冰敷膝盖与对侧膝盖相比血流减少的百分比以及随后锝在骨中的摄取减少的百分比。所有冰敷的膝盖均显示动脉和软组织血流减少以及骨摄取减少，这反映了骨血流和代谢的变化。动脉血流平均减少38.4%±4.97，软组织血流平均减少25.8%±2.04，骨摄取平均减少19.3%±2.0（各均值的标准误）。这种“冰敷效应”与年龄、性别、膝盖周长或冰敷后的皮肤温度无关。通过减少血流和细胞代谢，理论上冰敷可以在急性创伤性损伤情况下限制出血和细胞死亡。因此，本研究为在大型关节（无论是软组织还是骨骼）发生此类损伤时使用冰敷提供了科学依据。
