燒傷早期微循環(huán)功能障礙的本質(zhì)——“外壓”、“內(nèi)堵”

摘要： 目的探討燒傷早期微循環(huán)功能障礙的本質(zhì),為燒傷的發(fā)病和治療提供理論依據(jù)。方法對(duì)以往完成的有關(guān)微循環(huán)的臨床和實(shí)驗(yàn)研究進(jìn)行歸納分析,總結(jié)燒傷局部和全身微循環(huán)的形態(tài)學(xué)、組織間液含水量、血流動(dòng)力學(xué)、血液流變學(xué)等多項(xiàng)指標(biāo)的變化,分析組織細(xì)胞變性、壞死的發(fā)生機(jī)制。結(jié)果燒傷后局部和全身毛細(xì)血管通透性升高,組織間液含水量和壓力上升,毛細(xì)血管內(nèi)出現(xiàn)高凝狀態(tài)和微血栓形成。結(jié)論嚴(yán)重?zé)齻缙谖⒀h(huán)功能障礙的本質(zhì)是"外壓"、"內(nèi)堵",從而誘發(fā)細(xì)胞變性、壞死,為燒傷發(fā)病和再生療法提供理論依據(jù)。
Objective To explore the essence of microcirculation dysfunction of burn wounds at an early stage so as to provide theoretic evidence for the occurrence and treatment of burns.Methods By summarizing and analyzing the previous clinical and experimental studies related to microcirculation to see the topical and systemic microcirculation changes in terms of morphology,water content of interstitial fluid,haemodynamics,hemarheology and etc,and to further analyze the pathogenesis of tissue cell degeneration and necrosis.Results The permeability of local and systemic capillaries,and the water content of the interstitial fluid and interstitial fluid pressure were all elevated,the hypercoagulable state and micro- thrombus were observed in the capillaries.Conclusion The essence of microcirculation dysfunction of severe burn wounds at an early stage is the internal pressure and external blocking,which in turn induces the degeneration and necrosis of cells. This study would provide theoretic evidence for the burn pathogenesis and its regenerative therapy treatment.