本文選題：壓瘡 + 大鼠�。� 參考：《山西醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的通過建立SD大鼠的壓瘡動(dòng)物模型，比較不同壓力的作用形式（垂直壓力、摩擦力和剪切力）對(duì)大鼠壓瘡皮膚及肌肉組織在肉眼和病理學(xué)方面的變化；并比較血清超氧化物歧化酶(SOD)的活性、丙二醛(MDA)和一氧化氮(NO)含量的變化，為其納入壓瘡危險(xiǎn)因素評(píng)估表并給予相應(yīng)分值提供理論依據(jù)。 方法32只SD大鼠雌雄不限，麻醉后仰臥于倒置的玻璃注射器加壓裝置。此裝置用止血帶將空心玻璃管與玻璃注射器的空筒相連。在裝置內(nèi)加水，由水柱產(chǎn)生的壓力通過注射器的活塞可作用于大鼠后肢膝關(guān)節(jié)骨隆突處的皮膚組織。此處皮膚組織即為受壓部位。通過計(jì)算受壓部位的面積和加壓的重量，使此處皮膚組織受到9kPa的壓強(qiáng)。 將大鼠隨機(jī)分為4組：對(duì)照組（A組），大鼠仰臥于鼠板上，未施加任何壓力7.5小時(shí)后處死；垂直壓力組（B組），給予受壓部位垂直壓力2h再放松0.5h；摩擦力組（C組），給予受壓部位垂直壓力2h并在2h末用棉布在此處往返摩擦，摩擦距離為1cm，之后放松0.5h；剪切力組（D組），大鼠后肢受壓部位用膠貼向肢體遠(yuǎn)端牽拉0.3～0.5cm，同時(shí)壓迫此處皮膚組織2h再放松0.5h；各實(shí)驗(yàn)組均給予三個(gè)缺血(壓迫2h)-再灌注（放松0.5h）循環(huán)后處死。 肉眼觀察大鼠受壓部位皮膚完整性和顏色變化，在光鏡下觀察受壓部位的表皮及肌肉組織的病理學(xué)變化，并測(cè)定血清中超氧化物歧化酶(SOD)的活性、丙二醛(MDA)和一氧化氮(NO)的含量。 結(jié)果1、肉眼觀察：A組大鼠受壓部位顏色未見明顯改變且皮膚組織完整；B組大鼠皮膚完整，但與實(shí)驗(yàn)前相比皮膚轉(zhuǎn)為了紫紅色；C組大鼠受摩擦處皮膚發(fā)紅且有散在、針尖大小的點(diǎn)狀破損；D組大鼠皮膚組織較完整，但與實(shí)驗(yàn)前相比呈現(xiàn)暗紅色。 2、光鏡觀察：A組大鼠上皮組織結(jié)構(gòu)清楚，為復(fù)層鱗狀上皮。肌纖維排列緊密有序，橫紋清晰，呈編織狀排列。B組大鼠復(fù)層鱗狀上皮相對(duì)于A組變薄，結(jié)構(gòu)不清，細(xì)胞層次減少。肌纖維水腫明顯，間質(zhì)增寬，橫紋模糊。C組大鼠復(fù)層鱗狀上皮較B組變薄，甚至角化，結(jié)構(gòu)不清。肌纖維水腫明顯，間質(zhì)增寬，橫紋斷裂。D組上皮組織較薄，，結(jié)構(gòu)不清。肌纖維較B組水腫明顯，較疏松，橫紋斷裂較多，間質(zhì)水腫增寬。 各實(shí)驗(yàn)組受壓部位肉眼及光鏡觀察均出現(xiàn)損傷，其中剪切力組肌肉損傷比垂直壓力組更明顯；摩擦力組表皮損傷比垂直壓力組更明顯。 3、生化指標(biāo)檢測(cè)：各實(shí)驗(yàn)組與對(duì)照組比較：SOD活性、MDA和NO含量均有統(tǒng)計(jì)學(xué)意義（P0.01）。 各壓迫緩解組之間比較也均有統(tǒng)計(jì)學(xué)意義。其中，摩擦力組與垂直壓力組比較：SOD活性下降（P0.01）、NO含量下降（P0.05）、MDA含量增加（P0.05）。剪切力組與垂直壓力組比較：SOD活性和NO含量明顯下降（P0.01）,MDA含量明顯增加（P0.01）。剪切力組與摩擦力組比較：SOD活性下降（P0.05），NO含量下降（P0.01），MDA含量增加（P0.05）。 結(jié)論1、缺血再灌注引起了組織細(xì)胞損傷而導(dǎo)致壓瘡。 2、剪切力主要造成了深部組織的損傷。 3、摩擦力主要造成了表皮組織的損傷。 4、垂直壓力、摩擦力和剪切力可以納入壓瘡危險(xiǎn)因素評(píng)估表且分值依次遞增。
[Abstract]:Objective to establish a model of pressure ulcers in SD rats and to compare the changes in the skin and muscle tissue of pressure sore in rats with different forms of pressure (vertical pressure, friction force and shear force), and to compare the activity of serum superoxide dismutase (SOD), the content of malondialdehyde (MDA) and nitric oxide (NO), and the changes of the content of malondialdehyde (MDA) and nitric oxide (NO). The risk factors of pressure ulcer were assessed and the corresponding scores were provided.
Methods 32 SD rats and male and female rats were placed on the back of the inverted glass syringe pressure device. The device used a tourniquet to connect the hollow glass tube to the empty tube of the glass syringe. In the device, water was added to the device, and the pressure produced by the water column could be used in the skin tissue of the knee joint of the hind limbs of the rat by the piston of the syringe. The skin tissue is the compressed part. By calculating the area of the compressed part and the weight of the pressure, the skin tissue is subjected to the pressure of 9kPa.
The rats were randomly divided into 4 groups: the control group (group A), the rats were lying on the rat board with no pressure for 7.5 hours. The vertical pressure group (group B) gave the vertical pressure of the compression site 2H and then relaxed 0.5h; the friction force group (group C) gave the vertical pressure of the compression position 2H and then rubbed with cotton cloth here at the end of 2h, and the friction distance was 1cm. In the shear group (group D), the compression part of the hind limbs of the rats was pulled 0.3 to 0.5cm by glue to the distal extremities, and the skin tissue was compressed to relax 0.5h at the same time, and 0.5h was relaxed in the skin tissue. All the experimental groups were given three ischemic (oppressed 2H) reperfusion (relaxation 0.5h) and then executed after the circulation.
The skin integrity and color change of the pressed part of the rat were observed by the naked eye. The pathological changes of the epidermis and muscle tissue in the compressed part were observed under the light microscope, and the activity of superoxide dismutase (SOD) in the serum, the content of malondialdehyde (MDA) and nitric oxide (NO) in the serum were measured.
Results 1, naked eye observation: the skin color of group A rats was not obviously changed and the skin tissue was intact. The skin of group B rats was complete, but the skin turned to purplish red compared with that before the experiment; the skin of group C was red and scattered, the point shape of the needle tip was damaged; the skin tissue of group D rats was more complete, but compared with that before the experiment. It's dark red.
2, light microscope observation: the epithelial tissue structure of group A rats was clear, it was complex layer squamous epithelium. The muscle fibers arranged closely and orderly, the transverse lines were clear, and the.B group of rats were thinner than the A group. The structure was not clear, the cell level decreased. The muscle fiber edema was obvious, the interstitium was widened, and the cross layer blurred.C group was compared with the B group. Thinning, even diagonalization, the structure is not clear. The muscle fiber edema is obvious, the interstitium is widened. The epithelial tissue of the.D group is thinner and the structure is not clear. The muscle fiber is more obvious than the B group, looser, more transverse fracture and wider interstitial edema.
All the experimental groups were injured by naked eye and light microscope, and the muscle damage in the shear group was more obvious than that in the vertical pressure group, and the skin damage in the friction group was more obvious than that in the vertical pressure group.
3, biochemical index test: compared with the control group, SOD activity, MDA and NO contents in each experimental group were statistically significant (P0.01).
SOD activity decreased (P0.01), NO content decreased (P0.05) and MDA content increased (P0.05). The shear force group and the vertical pressure group were compared with the vertical pressure group: SOD activity and NO content decreased significantly (P0.01), MDA content increased significantly (P0.01). Shear force group and friction. Compared with the control group, SOD activity decreased (P0.05), NO content decreased (P0.01), and MDA content increased (P0.05).
Conclusion 1. Ischemia and reperfusion cause tissue cell injury and cause pressure ulcers.
2, the shear force mainly causes the damage of the deep tissue.
3, the friction force mainly causes the damage of the epidermis.
4, vertical pressure, friction and shear force can be included in the risk factors for pressure ulcer risk assessment.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R363

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 吳志萍;王麗燕;佟金諭;薛燕;;自制壓瘡評(píng)分表在ICU中的應(yīng)用[J];實(shí)用骨科雜志;2009年09期

2 蔡福滿;姜麗萍;楊曄琴;韋涇云;吳永琴;;皮膚壓瘡缺血再灌注損傷及其作用機(jī)制研究[J];護(hù)理研究;2006年16期

3 燕群美;;壓瘡動(dòng)物模型的研究進(jìn)展[J];護(hù)理研究;2009年25期

4 臧爽;李春麗;翟秀巖;;壓瘡大鼠缺血再灌注不同時(shí)間點(diǎn)血清中SOD、NO、MDA含量變化[J];護(hù)理研究;2009年26期

本文編號(hào)：2051674