高原复合冲击伤伤情特点的研究  

Study on characteristics of compound blast injury at plateau

作　　者：杨志焕[1] 李晓炎[1] 李素芝[2] 蒋建新[1] 宁心[1] 张良潮[1] 殷作明[2] 周继红[1] 尹志勇[1] 刘大维[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所,重庆400042 [2]成都军区西藏总医院,西藏拉萨850003

出　　处：《创伤外科杂志》2006年第5期422-424,共3页Journal of Traumatic Surgery

基　　金：军队"十五"医学科研基金重点课题(01Z076)

摘　　要：目的探讨猪高原复合冲击伤的伤情特点。方法将30只猪分为5组,每组各6只,于海拔3 500m处分别复制单纯冲击伤、15%体表面积Ⅱ°烧伤、一侧后肢高速弹片伤、烧冲复合伤和弹冲复合伤模型。用PCB公司生产的压力传感器测定冲击波的物理参数,观察伤后28小时动物活存情况和大体形态学改变。结果单纯烧伤组和单纯弹片伤组动物全部活存,均未见明显形态学改变。单纯冲击伤组可见中度肺出血和轻度肠道浆膜下出血,且动物均全部存活。烧冲复合伤组和弹冲复合伤组肺出血加重,半数动物(3/6)为重度肺出血,同时伴中度肺水肿,肠道未见加重效应。烧冲复合伤组2只动物分别于伤后16、10小时死亡,弹冲复合伤组1只动物于伤后3小时死亡。结论高原复合冲击伤与单纯冲击伤相比,具有伤情更重,死亡率更高的特点,加重效应的器官主要为肺脏,加重的程度大致为一个等级。Objective To explore the characteristics of compound blast injury at plateau. Methods Thirty pigs were divided into 5 groups （6 pigs in each group） ： single blast injury, 15% body surface burn injury（ Ⅱ degree） ,high velocity fragment injury of posterior limb, bum-blast combined injury and bullet-blast combined injury group. All the injury models were reproduced at 3500m plateau. The physical parameters of blast wave was recorded with PCB pressure transducers. The survival states and morphological changes 28 hours after injury was observed. Results All the animals in single blast injury and high velocity fragment injury groups survived, and no significant morphological change was found in the 2 groups. Moderate lung hemorrhage and mild subserous bleeding of intestinal tract appeared in blast injury group,and animals survived. More severe lung hemorrhages were found in burn-blast combined injury and bullet-blast combined injury groups. Severe lung hemorrhage accompanied by moderate lung edema was found in half of the animals （ 3/6 ） , but no aggravating effects of intestinal tract were found. Two animals of bum-blast combined injury group died 10 and 16 hours after injury respectively. One animal in bullet-blast combined injury group died 3 hours after injury. Conclusion Compared with single blast injury,high plateau combined blast injury is characterized by severe injuries and higher mortality. The aggravating effects mainly occur in lung, and its degree is usually about one grade higher.

关 键 词：复合冲击伤 伤情特点 高原 

分 类 号：R641[医药卫生—外科学] R826.5[医药卫生—临床医学]