摘要
目的 探讨骨折后髓内钉固定及手术时机的选择对肺血流动力学的影响。方法 选择成年雌性杂种犬 24只，随机分成 3组，每组 8只，模拟股骨干骨折。第一组于骨折后 6 h做髓内钉固定，为 6 h组；第二组于骨折后 48 h做髓内钉固定，为 48 h组；另一组骨折后不做髓内钉固定，为对照组。分别测定各组不同时间的髓内压、肺动脉压，并进行血气分析。然后处死动物，取肺组织做病理学检查，应用 IA-3001影像分析系统测定每个视野中脂肪微粒所占百分比。结果 (1)扩髓时髓内压达到最高峰， 6 h组与 48 h组髓内压变化比较，差异无显著性意义（ P >0.05）。术后 1 h髓内压降至扩髓前水平。 (2)扩髓及髓内钉固定后，肺动脉压明显升高 (P0.05）。 (3)扩髓及插入髓内钉对血气变化无明显影响。 (4)6 h组与 48 h组肺组织中脂肪颗粒比较，差异无显著性意义（ P >0.05）。结论 髓内钉治疗长管状骨骨折对肺血流动力学无明显影响，且早期手术对肺血流动力学也无影响。
Objective To investigate the effect of intramedullary nailing on the pulmonary blood dynamics and timing for the operation. Methods Twenty-four adult dogs were used in this study. Femoral fracture model was created in all animals and divided into 3 groups at random. The intramedullary nailing was performed 6 hours after the fracture in group 1, 48 hours after the fracture in group 2, and no fixation was performed in control group. The intramedullary pressure, the pulmonary arterial pressure and the blood gas analysis were measured. The lungs were examined for pathological evidence of fat particles. Results 1)The intramedullary pressure increased significantly during reaming, and decreased to normal 1 hour after nailing. But there was no significant difference between two experimental groups(P >0.05). 2) The pulmonary arterial pressure increased significantly after reaming and nailing in experimental groups(P0.05). 3) No significant difference was found in the blood gas analysis among all groups(P >0.05). 4) No difference was seen with respect to the amount of embolic fat in lung tissue between two experimental groups(P >0.05). Conclusion It appears that early fixation of long bone fractures with intramedullary nail has little influence on pulmonary blood dynamics.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第11期689-692,共4页
Chinese Journal of Orthopaedics
关键词
骨折固定术
髓内钉
肺血流动力学
脂肪栓塞
Lung
Embolism, fat
Hemodynamics
Fracture fixation, intramedullary
