构建猪胸腰段脊髓火器伤后全瘫模型的局部病理和血电解质变化  

Changes of local pathology and blood electrolure in pamplegia models after gunshot injury to spinal cord of chest and lumbar section in porcins

作　　者：陈长青[1] 李家顺[1] 贾连顺[1] 梁朝革[1] 

机构地区：[1]解放军第二军医大学长征医院骨科,上海市200003

出　　处：《中国临床康复》2005年第37期84-86,共3页Chinese Journal of Clinical Rehabilitation

基　　金：全军"十五"计划指令性课题基金(01L056)~~

摘　　要：目的:建立家猪胸腰段脊髓火器伤和改良Allens打击伤后全瘫模型,观察伤后家猪脊髓局部病理和早期血电解质的变化。方法:实验于2004-06/09在解放军第二军医大学动物实验中心完成。选取清洁级健康雄性实验小型家猪12只,随机分为火器伤组和打击伤组,每组6只。火器伤组在全麻状态下制作胸腰段L1～L2脊髓火器伤模型;打击伤组在L1节段脊髓行改良Allens打击。各组动物分别于伤前及伤后0.5,1,2,4h检测血电解质,死亡动物行病理解剖检查。结果:按意向处理分析,12只家猪均纳入结果分析。①火器伤组实验动物在伤后5.2～7.5h死亡,死亡率100%;打击伤组在火器伤组动物死亡后中止麻醉,复苏期过后无死亡。②打击伤组五个时间点的血钾差别无统计学意义(F=0.58,P=0.6795);火器伤组五个时间点的血钾差别有统计学意义(F=25.29,P<0.0001),伤后4h内血钾浓度高于伤前,成升高趋势。③火器伤组弹道周围广泛挫伤,肾包膜及肾实质广泛充血、出血。结论:缘于火器伤特殊的损伤机制,火器伤组较打击伤组肾脏损伤及组织破坏严重,在伤后早期出现高钾血症。AIM：To build porcine models with gunshot in spinal cord of breast and lumbar section and pamplegia models injured with modified Alien＇s method, and observe local pathology in spinal cord and early changes of blood and electrolure in injured porcine. METHODS：The experiment was conducted at the animal laboratory center, Second Military Medical University from June to September 2004. Twelve clean-grade small-type healthy male porcins were selected,and randomly divided into gunshot injury group and Alien method induced injury group with 6 in each group. Gunshot injured models were made at the L1-L2 chest and lumbar section in the gunshot injury group under anesthesia of the whole body. Those in the Allen method induced injury group were treated with modified Alien method at the L1 section of spinal cord. The blood and electrolure after injured for 0.5, 1, 2 and 4 hours in every group before and after injured, respectively. Pathological dissection test was performed in dead animals. RESULTS： According to the intention-to-treat analysis,12 porcins were all involved in the result analysis. ① The experimental porcins in the gunshot injury group died after injured for 5.2 to 7.5 hours with 100% death rate. The anesthesia was stopped in the Allen method induced injury group after the death of animals in the gunshot injury group. There was no death after recovery phase. ② The difference of blood potassium had no statistics meaning at five time points in the Allen method induced injtay group （F=0.58,P=0.6795）; The difference d blood potassium had statistics meaning at five time points in the gunshot injury group （F=25.29,P〈0.0001）,The blood potassium was higher within 4 hours after injury than before injury, showing increasing tendency. ③ Around bomb pathway there was much wound in the gunshot injury group.Extensive congestion and hemorrhage were observed below the peplos and renal parenehyma. CONCLUSION：Gunshot injury with specific mechanism has done more kidney injury and tissue damage than Allen

关 键 词：脊髓 火器 病理 电解质 高钾血症 

分 类 号：R628.22[医药卫生—整形外科]