The protective effect of fasciotomy combined with hypertonic saline flushing for crush syndrome in rats.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE SHOCK Pub Date : 2024-08-20 DOI:10.1097/SHK.0000000000002452

Yaqian Wen, Xiaoge Wang, Jie Zhang, Lei Rong, Wenjie Ren, Linqiang Tian, Liangming Liu

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Abstract

Abstract: In natural disasters such as earthquakes and landslides, the main problem that wounded survivors are confronted with is Crush Syndrome (CS). The aim of this study was to explore more convenient and effective early treatment measures for it.In the present study, we investigated the protective effect of fasciotomy combined with different concentration of hypertonic saline flushing with CS rats. CS model was prepared by compressing the buttocks and both lowering limbs of rats with 7.5 kg dumbbell for 4 hours. The rats were divided into 10 groups, which were normal control group, model group, incision without flushing group, 0.45%, 0.9%, 3%, 5%, 7% saline group, 3%-0.45% and 7%-0.45% saline alternating flushing group respectively. 6 hours after the treatment, the blood was sampled for measurement of the potassium, calcium, AST, ALT, Cr, Urea, myoglobin, and lactic acid content. The blood flow of the compressed tissue and kidneys, the pathological changes of the kidneys and the survival rate of 3%-0.45% saline alternating flushing group were also observed.The experimental results showed that fasciotomy alone for treatment cannot improve the presentation of CS of rats. Instead, hypertonic saline flushing significantly improved the AST, ALT, Cr, Urea indices, blood flow of muscles and kidneys. It also enormously decreased the blood K+, myoglobin, lactic acid concentration and slight increased the blood Ca2+. Among them, alternating flushing with 3%-0.45% saline had the best therapeutic effect on CS. Finally, it can be found that 3%-0.45% saline treatment regimen dramatically raised the survival rate of CS rats.All in all, this study suggests that fasciotomy combined with hypertonic saline flushing is a good therapeutic approach for CS.

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筋膜切开术联合高渗盐水冲洗对大鼠挤压综合征的保护作用。

摘要：在地震和山体滑坡等自然灾害中，受伤幸存者面临的主要问题是挤压综合征（CS）。本研究探讨了筋膜切开术联合不同浓度的高渗盐水冲洗对 CS 大鼠的保护作用。用 7.5 千克哑铃压迫大鼠臀部和双下肢 4 小时，制备 CS 模型。大鼠分为 10 组，分别为正常对照组、模型组、切口不冲洗组、0.45%、0.9%、3%、5%、7%生理盐水组、3%-0.45%和 7%-0.45%生理盐水交替冲洗组。治疗 6 小时后，采血测定钾、钙、AST、ALT、Cr、尿素、肌红蛋白和乳酸含量。实验结果表明，单纯的筋膜切开术并不能改善大鼠 CS 的表现。实验结果表明，单纯的筋膜切开术并不能改善大鼠的 CS 表现，相反，高渗盐水冲洗能明显改善大鼠的 AST、ALT、Cr、尿素指数以及肌肉和肾脏的血流量。它还大大降低了血液中的 K+、肌红蛋白和乳酸浓度，并使血液中的 Ca2+略有升高。其中，用 3%-0.45% 生理盐水交替冲洗对 CS 的治疗效果最好。总之，本研究表明，筋膜切开术联合高渗盐水冲洗是治疗 CS 的一种良好方法。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.