Influence of haemorrhagic shock on fracture healing
Influence of haemorrhagic shock on fracture healing
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DOI：
10.1007/s00423-003-0405-3
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发表时间：
2003-10-01
影响因子：
2.3
通讯作者：
Augat, P
中科院分区：
文献类型：
--
作者：
Bumann, M;Henke, T;Augat, P
背景本研究的目的是评估出血性休克对骨折愈合结局的影响。材料和方法。42只雄性Wistar大鼠随机分为对照组和休克组。在造成胫骨骨折后，我们通过造成12 ml/kg体重的失血量诱导休克。用胶体体积溶液等体积复苏大鼠。用激光多普勒血流仪测量血流量。4周后通过三点弯曲测试力学性能。结果休克组的血流量的特点是在第一个24小时内远端区域和软组织中没有减少，而对照组的血流量减少到骨折前水平的39%。生物力学测试显示，在失效载荷（31/11 N; P=0.06）和弯曲刚度（22,7/4,7 Nmm（2）; P=0.07）方面，休克组的骨折愈合结果优于对照组。结论.在休克组中，在愈合的早期阶段，由等容复苏引起的远端区域和软组织中的血管再生的恢复导致骨折愈合的增强。此外，结果表明，快速血液供应可能会产生改善的初始愈合过程，导致骨愈合的机械结果增加。总的来说，我们的研究结果强调了血供与骨折愈合之间的密切关系。
Background. The purpose of the study was to evaluate the effect of haemorrhagic shock on the outcome of fracture healing. Material and methods. Forty-two male Wistar rats were randomly divided into a control group and a shock group. After producing a tibia fracture we induced shock by creating a blood loss of 12 ml/kg body weight. The rats were isovolumetrically resuscitated with a colloid volume solution. Blood flow was measured by laser Doppler flowmetry. Mechanical properties were tested by three-point bending after 4 weeks. Results. The blood flow of the shock group was characterised by no reduction in the distal region and in the soft tissue in the first 24 h, while the flow in the control group was reduced to 39% of the pre-fracture level. Biomechanical testing showed a better fracture healing outcome for the shock group than for the control group in failure load (31/11 N; P=0.06) and flexural rigidity (22,7/4,7 Nmm(2); P=0.07). Conclusions. In the shock group the restoration of vascularity in the distal region and in the soft tissue in the early healing stages, provoked by the isovolumic resuscitation, led to enhanced fracture healing. In addition, the results indicate that a fast blood supply may generate an improved initial healing process that results in an increased mechanical outcome of bone healing. In general, our findings underline the close interrelation between blood supply and successful fracture healing.