早期应用大剂量青霉素钠对犬颅脑爆震伤的影响  

Effect of early application of penicillin sodium at high doses on craniocerebral explosive injury in dogs

作　　者：张广林[1] 贺世明[1] 张相安[2] 王占江[3] 高波[1] 于嘉[1] 高国栋[1] 

机构地区：[1]第四军医大学唐都医院神经外科 [2]中国人民解放军71282部队医院 [3]西北核技术研究所

出　　处：《第四军医大学学报》2007年第9期802-805,共4页Journal of the Fourth Military Medical University

基　　金：全军"十一五"军事医学重点课题(05XJM005)

摘　　要：目的:观察早期应用大剂量青毒素钠对颅脑爆震伤实验犬的救治效果.方法:将杂种犬20只制成点爆炸源颅脑爆震伤模型,随机分为对照组(n=8)及实验组(青霉素钠组,n=12),观察每组伤后血浆内毒素(ET)、肿瘤坏死因子(TNF)、谷丙转氨酶(ALT)、血淀粉酶(AMY)、尿素氮(BUN)、肌酸激酶(CK)含量及伤口大体情况(0,4,8,12,24,48h)、细菌培养水平、生存时间.结果:①颅脑爆震伤后两组血浆ET,TNF,ALT,AMY,BUN,CK水平均显著升高(P<0.05),而伤后24h实验组水平开始显著低于对照组(P<0.01);②对照组的伤口组织坏死、感染情况明显比实验组早且更严重;③实验组血液细菌培养革兰氏阳性菌及厌氧菌总阳性率(1/12)显著低于对照组(6/8)(P<0.01);④实验组的生存时间为132.6h,明显长于对照组96.5h(P<0.01).结论:颅脑爆震伤后早期应用大剂量青毒素钠可减少机体感染革兰氏阳性菌及厌氧菌的机率,减轻继发损伤的程度,延长机体创伤后存活时间.AIM： To explore treatment effects of early applica- tion of penicillin sodium at high doses on craniocerebral explosive injury in dogs. METHODS： Twenty mongrel dogs were estab- lished into a new model of craniocerebral explosive injury and then randomly divided into control groups （n = 8 ） and experiment groups （penicillin sodium, n = 12）. The levels of plasma endo- toxin （ET）, tumor necrosis factor （TNF）, alanine aminotrans- ferase （ ALT）, amylase （ AMY）, blood urea nitrogen （ BUN）, creatine kinase （CK）, the survival time of injured dogs were de- termined; The gross condition in the wound was observed and bac- terial culture was performed 0, 4, 8, 12, 24, 48 h after cranioce- rebral explosive injury in dogs. RESULTS： ① The plasma levels of ET, TNF, ALT, AMY, BUN, CK in both penicillin sodium group and control group were increased significantly after cranio- cerebral explosive injury （ P 〈 0.05 ） ; however, the plasma levels of ET, TNT, ALT, AMY, BUN, CK in the former group were lower than the latter from 24 h after craniocerebral explosive injury （ P 〈 0.01 ） ; ② The necrosis and infection of wounded tissue sig- nificantly earlier occurred and were more serious in control group as compared to penicillin sodium group; ③ The positive rates of gram positive bacteria and anaerobic bacteria in penicillin sodium group （1/12） were lower than those in control group （6/8） after cranioeerebral explosive injury （P 〈0.01 ）. ⑤ The survival time of penicillin sodium group （ 132.6 h） was longer than that of con- trol a＇roun （96.5 h. P 〈 0.01 ）. CONCLUSION： Early orooertreatment with penicillin sodium at high doses for craniocerebral explosive injury in dogs can reduce the infection incidences of gram positive bacteria and anaerobic bacteria, relieve the secon- dary injury, and prolong the mean survival time of the injured dogs.

关 键 词：爆震伤 颅脑损伤 救治 青毒素钠 犬 

分 类 号：R651.1[医药卫生—外科学]