高原高寒战时环境肢体火器伤后应激反应的特点  

Dynamic changes of hydrocortisone and adrenalin in plasma at stress on gunshot wound in pig limbs in high altitude and cold war environment

作　　者：殷作明[1] 胡德耀[1] 李素芝[2] 杨志焕[1] 叶峰[2] 刘良明[1] 石权贵[2] 宋俊[2] 林秀来[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所第二研究室,创伤,烧伤与复合伤国家重点实验室,重庆400042 [2]西藏军区总医院骨科,拉萨850003

出　　处：《第三军医大学学报》2005年第7期581-583,共3页Journal of Third Military Medical University

基　　金：全军"十五"指令性课题 ( 0 1L0 0 8)~~

摘　　要：目的　探讨高原高寒环境下肢体火器伤后全身应激反应的特点。方法　将2 4头猪随机分为高原战时致伤组(GZ)、高原平时致伤组(GP)和平原平时致伤组(PP) ,每组8只、复制肢体火器伤模型。分别于伤前、伤后10、3 0min、2、6、12、2 4、48、72、12 0h采静脉血测定血浆氢化可的松和肾上腺素。结果　3组猪血浆氢化可的松含量均于伤后10min明显升高、3 0min达高峰,高原战时致伤组血浆氢化可的松含量增高幅度最大,约为高原平时致伤组的2倍、平原平时致伤组的4倍;高原战时致伤组血浆肾上腺素含量于伤后10min明显升高并达高峰,约为伤前的40倍、高原平时致伤组的1 5倍、平原平时致伤组的1 8倍。平原平时致伤组血浆氢化可的松和肾上腺素含量均在伤后48h恢复到正常水平,高原平时致伤组在伤后72h时恢复到正常水平,高原战时致伤组在伤前血浆氢化可的松和肾上腺素含量就大大高于其它两组,一直到伤后12 0h仍然保持在较高水平。结论　高原高寒环境战时猪肢体枪弹伤后全身应激反应明显重于高原平时致伤组和平原平时致伤组,而且持续的时间长。Objective To investigate the changes of hydrocortisone and adrenalin in plasma at stress after gunshot wound in pig limbs in the high altitude and cold war environment. Methods Twenty-four pigs were divided into 3 groups: normal environment group (PP, n=8), high altitude and cold environment group (GP, n=8), and high altitude and cold war environment group (GZ, n=8). Gunshot wound in the posterior limbs was induced in different environments. The content of hydrocortisone and adrenalin in plasma was measured at different time points after injury. Results The content of hydrocortisone in plasma increased in 10 min after injury in 3 groups, and reached the peak at 30 min, which increased most in GZ group, almost 2-fold than that of GP group, and 4-fold than that of PP group. The content of adrenalin in plasma increased in 10 min and reached the peak at 10 min after injury in 3 groups, which increased most in GZ group, almost 40-fold than that before injury, 1.5-fold than that of GP group, and 1.8-fold than that of PP group. The content of hydrocortisone and adrenalin in plasma returned to normal level in 48 h in PP group and in 72 h in GP group. The content of hydrocortisone and adrenalin in plasma before injury in GZ group was higher than the other 2 groups, and maintained at the high level till 120 h. Conclusion Dynamic changes of hydrocortisone and adrenalin in plasma after gunshot wound in pig limbs in high altitude and cold war environment are more obvious than those of normal environment and high altitude and cold environment, and will keep at a high level for a long time.

关 键 词：高海拔 高寒 战争 枪弹伤 应激反应 氢化可的松 肾上腺素 

分 类 号：R339.54[医药卫生—人体生理学] R363[医药卫生—基础医学]