准静态下颞骨撞击伤模型的建立  

Establishment of temporal bone impact injury model

作　　者：杨成[1] 陈继川[1] 尹志勇[2] 陈金华[3] 姬长友[1] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所耳鼻咽喉-头颈外科,重庆400042 [2]第三军医大学附属大坪医院第四研究室 [3]第三军医大学附属大坪医院放射科

出　　处：《中华创伤杂志》2007年第6期441-444,共4页Chinese Journal of Trauma

摘　　要：目的 建立颞骨撞击伤模型，研究不同撞击模式下颞骨骨折的发生情况，探讨颞骨撞击后损伤的发生特点与机制。方法 选取成人尸头12具，撞击前于螺旋CT下行横断面、冠状面扫描。将头颅固定于BIM—Ⅱ型生物撞击机致伤架上，使撞击部位暴露于二次锤的正前方并与二次锤的中心重合，分别选取800，1200，1400kPa的驱动压力进行撞击，将撞击后尸头于螺旋CT下行横断面、冠状面扫描，将撞击后螺旋CT影像与撞击前对照研究分析。结果 建立了3种不同损伤程度的颞骨撞击伤模型：（1）800kPa撞击组主要为软组织的损伤，颞骨骨折只局限在某些层面发生；（2）1200kPa撞击组除撞击侧颞骨发生线性骨折外，并可波及到对侧颞骨形成对冲性骨折；（3）1400kPa撞击组撞击侧颞骨发生混合型骨折或粉碎性骨折，并形成了对冲性骨折。结论 建立的3种程度颞骨撞击伤模型可以反映出颞骨撞击后3种不同损伤特点的颞骨骨折，对交通事故中颞骨撞击伤的防治研究有重要的意义。Objective To establish temporal bone impact injury models for researching the certain situations of the temporal bone fracture in disparate impact patterns so as to investigate the features and mechanisms of the temporal bone fracture after the temporal bone impact. Methods Cross and coronal scans were done on 12 human cadaver heads with SCT before the impact. The cadaver heads were fixated on the stand of the type BIM- Ⅱ biologic impact machine and exposed the impact area to the obverse front side of the impact tip and merged the central area of the impact tip and then given driving pressures of 800 kPa, 1 200 kPa, 1 400 kPa to the impact areas. Then, the impacted cadaver heads were scanned at cross and coronal sections with SCT to compare with the scanning data before the impact. Results Three different levels of temporal bone impact injury models were established. （ 1 ） The 800 kPa impact injury model could be defined as the soft tissue damage and temporal bone fracture, the latter of which was constrained to some certain stratifications;（2） The 1 200 kPa impact injury model could be defined as the ipsilateral temporal bone linearity fracture, with contrecoup fracture after the impact; （3） The 1 400 kPa impact injury model could be defined as the mixed or comminuted ipsilateral temporal fractures and resulted in contrecoup fracture after the impact. Conclusion The establishment of the models at three different levels of temporal bone impact injury reflects the different degree of temporal bone injury, as may be important for prevention and treatment of temporal bone impact injury in traffic accidents.

关 键 词：创伤和损伤 撞击 颞骨 模型 骨折 

分 类 号：R686[医药卫生—骨科学]