Curl W W, Smith B P, Marr A, Rosencrance E, Holden M, Smith T L
Department of Orthopaedic Surgery, Bowman Grey School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1070, USA.
J Sports Med Phys Fitness. 1997 Dec;37(4):279-86.
The most common treatment of soft tissue contusions is ice application (cryotherapy). The physiological basis for this therapy is assumed to be cold-mediated vasoconstriction resulting in decreased edema formation and a reduction in overall morbidity. This proposed mechanism has not been tested. The present research examined the hypothesis that cryotherapy following contusion is effective because it reduces microvascular perfusion and subsequent edema formation.
The microcirculatory responses to contusion were studied with and without cryotherapy in a chronically instrumented rat model. Initial studies evaluated the immediate effects of cryotherapy on arteriolar and venular diameters and microvascular perfusion (using laser Doppler floxmetry). Variables were measured before and immediately after 20 minutes of cryotherapy. Two additional studies monitored the same microvascular parameters longitudinally in four sets of chronically instrumented animals. Groups of rats studied had contusion or sham contusion with ice treatment or no ice treatment. Measurements were performed repeatedly before and after treatment for 24 hours or 96 hours after contusion/sham contusion.
The acute microvascular effects of cryotherapy were vasoconstriction and decreased perfusion. However, when cryotherapy was used as a treatment following contusion/sham contusion, there were no long-lasting microvascular effects of cryotherapy either in the presence or absence of contusion.
These results indicate that cryotherapy of striated muscle following contusion does not reduce microvascular diameters or decrease microvascular perfusion. Alternate mechanisms of action for cryotherapy treatment need to be investigated.
软组织挫伤最常见的治疗方法是冰敷（冷冻疗法）。这种疗法的生理基础被认为是寒冷介导的血管收缩，从而减少水肿形成并降低总体发病率。这一提出的机制尚未得到验证。本研究检验了以下假设：挫伤后进行冷冻疗法是有效的，因为它能减少微血管灌注及随后的水肿形成。
在一个长期植入仪器的大鼠模型中，研究了有或没有冷冻疗法时挫伤对微循环的反应。初步研究评估了冷冻疗法对小动脉和小静脉直径以及微血管灌注的即时影响（使用激光多普勒血流仪）。在冷冻疗法20分钟之前和之后立即测量变量。另外两项研究在四组长期植入仪器的动物中纵向监测相同的微血管参数。所研究的大鼠组有挫伤或假挫伤，并接受冰敷治疗或不接受冰敷治疗。在挫伤/假挫伤后24小时或96小时，在治疗前后反复进行测量。
冷冻疗法的急性微血管效应是血管收缩和灌注减少。然而，当在挫伤/假挫伤后使用冷冻疗法作为治疗时，无论有无挫伤，冷冻疗法都没有长期的微血管效应。
这些结果表明，挫伤后对横纹肌进行冷冻疗法不会减小微血管直径或降低微血管灌注。需要研究冷冻疗法治疗的其他作用机制。
