冰敷减轻水肿:大鼠微血管通透性的研究

D. Deal, J. Tipton, E. Rosencrance, W. Curl, Thomas L. Smith
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引用次数: 145

摘要

背景:根据临床资料,冰敷应用于软组织损伤后。本研究通过测定冰敷前后和不冰敷前后的微血管通透性来研究冰敷(冷冻疗法)和水肿之间的关系,并提供支持冷冻疗法后水肿减少的数据。方法:建立大鼠背侧微血管室,直接检测清醒大鼠皮肤大肌完整、预先建立的微血管床的微血管参数。大鼠经挫伤或假性挫伤后进行冷冻治疗或不进行冷冻治疗。通过测量挫伤前后间质液中荧光标记白蛋白来评估微血管通透性(水肿)。结果:与假挫伤不冷冻组(对照组)相比,挫伤不冷冻组挫伤后微血管通透性显著增加(p < 0.001)。挫伤后15分钟冰敷20分钟,微血管通透性(水肿)较挫伤后未冰敷组明显降低(p < 0.001)。挫伤后冷冻组的通透性较对照组有所增加(p = 0.012),但其增加幅度不如挫伤不冷冻组与对照组的增加幅度大。与对照组相比,假挫伤联合冷冻治疗显著降低微血管通透性(p = 0.004)。与基线测量值相比,未经冷冻治疗的假挫伤在300分钟后毛细血管后小静脉的微血管通透性没有显著变化。结论:冰敷可显著降低横纹肌挫伤后微血管通透性。本研究结果表明,微血管通透性增加后,挫伤与显著白细胞内皮相互作用相一致。然而,微血管通透性在冷冻治疗后显著降低,这种治疗被证明可以减少滚动和粘附的白细胞的数量。这一关联表明,冷冻治疗后受伤骨骼肌水肿的减少可能是由于白细胞内皮相互作用的减少。临床意义:本研究为冰敷减轻水肿的临床观察提供了科学依据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ice Reduces Edema: A Study of Microvascular Permeability in Rats
Background: Ice is applied following a soft-tissue injury on the basis of clinical information. This study investigates the relationship between ice therapy (cryotherapy) and edema by determining microvascular permeability before and after contusion with and without ice therapy and provides data supporting a reduction in edema following cryotherapy.Methods: A dorsal microvascular chamber was created in rats to allow the direct examination of microvascular parameters in intact, pre-established microvascular beds of the cutaneous maximus muscle in conscious rats. The rats received a contusion or sham contusion and were treated with cryotherapy or were not treated. Microvascular permeability (edema) was assessed by measuring fluorescent-labeled albumin in the interstitial fluid before and after contusion.Results: Microvascular permeability following contusion was significantly increased in the group that received the contusion without cryotherapy compared with that in the group that received the sham contusion without cryotherapy (control) (p < 0.001). When ice was applied fifteen minutes after the contusion for twenty minutes, microvascular permeability (edema) decreased significantly (p < 0.001) compared with that in the group that did not receive cryotherapy after contusion. Permeability was increased in the group that received cryotherapy following the contusion compared with that in the control group (p = 0.012), although the increase was not as great as that between the group that received the contusion without cryotherapy and the control group. Sham contusion with cryotherapy significantly reduced microvascular permeability compared with that in the control group (p = 0.004). Sham contusion without cryotherapy did not cause a significant change in the microvascular permeability of postcapillary venules after 300 minutes compared with baseline measurements.Conclusions: The application of ice significantly decreased microvascular permeability following striated muscle contusion. The results of this study demonstrated that microvascular permeability is increased following a contusion coincident with significant leukocyte-endothelial interactions. However, microvascular permeability was significantly reduced following cryotherapy, a treatment demonstrated to reduce the number of rolling and adherent leukocytes. This association suggests that the reduction in edema in injured skeletal muscle following cryotherapy may be due to a reduction in leukocyte-endothelial interactions.Clinical Relevance: This study provides scientific data to support the clinical observation that ice reduces edema.
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