Hord A H, Denson D D, Huerkamp M J, Seiler J G
Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Anesth Analg. 1999 Jan;88(1):103-8.
This study was performed to determine the changes in perfusion that occur after chronic constriction injury (CCI). Male Sprague-Dawley rats weighing 275-300 g had loosely constricting ligatures placed around the left sciatic nerve. Paw withdrawal latency (PWL) to heat, skin temperature, and skin perfusion (laser Doppler) of the hind paws were measured before and for 30 days after CCI. PWL decreased significantly on the side of the CCI (maximum of 34% decrease on Postoperative Day [POD] 3), then returned to normal over a 20-day period. Skin temperature initially increased on the side of CCI, then decreased with respect to the control limb on PODs 20-30. Despite the initial increase in skin temperature on the side of CCI, skin perfusion significantly decreased immediately after CCI (maximum of 51% decrease on POD 6). The perfusion gradually returned to normal over 20 days. Because return to normal perfusion occurred while the skin temperature became colder than the control side, we conclude that there is no relationship between paw surface temperature and perfusion.
Our data suggest that loss of sympathetic tone in thermoregulatory arteriovenous anastomoses leads to decreased nutritional blood flow to the skin of the affected limb after chronic constriction injury, which is consistent with the findings reported in humans with reflex sympathetic dystrophy.
本研究旨在确定慢性缩窄性损伤（CCI）后发生的灌注变化。体重275 - 300克的雄性Sprague-Dawley大鼠，在左坐骨神经周围放置宽松的缩窄结扎线。在CCI前及CCI后30天测量后爪对热的缩爪潜伏期（PWL）、皮肤温度和皮肤灌注（激光多普勒）。CCI侧的PWL显著降低（术后第3天最大降低34%），然后在20天内恢复正常。CCI侧皮肤温度最初升高，然后在术后第20 - 30天相对于对照肢体降低。尽管CCI侧皮肤温度最初升高，但CCI后皮肤灌注立即显著降低（术后第6天最大降低51%）。灌注在20天内逐渐恢复正常。由于在皮肤温度比对照侧更冷时灌注恢复正常，我们得出结论，爪表面温度与灌注之间没有关系。
我们的数据表明，慢性缩窄性损伤后，体温调节动静脉吻合处交感神经张力丧失导致受影响肢体皮肤的营养性血流减少，这与反射性交感神经营养不良患者的报道结果一致。
