海水中肢体火器伤伤后伤道细菌种类分析  

Bacterial analysis of limb wound tract after gunshot wound in seawater

作　　者：孟辉[1] 申洪[2] 卜海激[2] 刘高望[2] 朱天岭[2] 吴正蓉[2] 张鋆歆[2] 

机构地区：[1]兰州军区兰州总医院普胸外科,甘肃兰州730050 [2]南方医科大学病理学教研室

出　　处：《西北国防医学杂志》2007年第2期98-100,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：全军"十五"医药卫生科研基金资助项目(01MA126)

摘　　要：目的:观察海水中犬肢体火器伤后伤道早期细菌变化,结合文献探讨初期外科处理。方法:将17只普通级毕格犬分为海水中致伤组(n=14)和地面致伤组(n=3)。海水组于海水中枪伤后救出,伤后0、6、12、24 h进行伤道细菌检测和药敏试验。地面组为观察对照。结果:伤肢肿胀、组织坏死和动物死亡时间,海水组均较地面组严重和提前;海水组革兰氏阳性球菌和革兰氏阴性杆菌较多,以链球菌、金黄色葡萄球菌、大肠杆菌为主的混合感染,头孢菌素、氨基糖甙类对多种细菌敏感。结论:海水中火器伤后细菌数量种类多,感染时间提前且严重,处理更应强调尽早彻底清创、早期使用广谱抗生素。Objective：To investigate the early - stage bacteria change and surgical treatment of the wound tracts of the limbs in dogs undergoing gunshot in seawater. Methods： Fourteen conventional Beagles models with gunshot wound in seawater were established, and another 3 dogs receiving gunshot wound without seawater immersion served as control. After the dogs undergoing gunshot wound in seawater were extricated, germ detection and medicament experimentation were performed at 0, 4, 6, 8, 12 and 24h respectively. Results： Compared with on land, more severe swelling and tissue necrosis around the wound were observed and a shorter pathological period was found after gunshot in seawater, with more Gram -positive cocci and Gram -negative bacilli. The mixed infection mainly resulted from streptococcus, staphylococcus aureus and colon bacillus. Conclusion： Severe bacterial infection may develop after gunshot wound in seawater. Broad - spectrum antibiotics and complete debridement should be recommended in early stage.

关 键 词：火器伤 海水 细菌学 清创术 

分 类 号：R826.5[医药卫生—临床医学]