实验性肝脏撞击伤的生物力学机制研究  

Experimental study on biomechanical mechanism of liver impact injury

作　　者：麻晓林[1] 杨志焕[2] 王正国[2] 朱佩芳[2] 安波[3] 李兵仓[3] 王大田[3] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军战创伤中心,重庆400042 [2]第三军医大学大坪医院野战外科研究所四室,重庆400042 [3]第三军医大学大坪医院野战外科研究所六室,重庆400042

出　　处：《创伤外科杂志》2007年第4期351-354,共4页Journal of Traumatic Surgery

摘　　要：目的探讨和分析肝脏撞击伤的生物力学机制。方法新西兰兔麻醉后,快速推注60%泛影葡胺40ml,用BIM-Ⅳ型生物撞击机致伤,在钢球撞击剑突致伤的同时,400KV高速脉冲X线机在不同延迟时间拍摄撞击瞬间腹腔及肝脏的变形情况。结果动物腹腔在急剧的压缩变形之后恢复得较为缓慢,受撞击后0.5毫秒,腹腔被压缩至最大,达4.32cm(达腹腔厚度的65.2%)。腹腔压缩变形的同时,肝脏发生严重的压缩与变形,在撞击方向上最大可被撞击压缩3.74cm(压缩量为71.3%),肝脏与心、肺之间还产生明显的不均匀性变形和位移,心尖向上的垂直位移达1.18cm。结论肝脏撞击伤的主要力学机制是能量通过腹腔急剧的压缩变形而直接压迫肝脏,使其产生严重的相对位移和不均匀性压缩变形,同时肝脏与心、肺之间还产生明显的不均匀性变形和位移,这可能是合并心、肺损伤的主要原因。Objective To investigate and analyse on biomechanical mechanism of liver impact injury.Methods After New Zealand rabbits were anethetized anaesthesia,60% meglucamine diatrizoate were injected speedily. Vulnerated by BIM-Ⅳ bioimpactmachine,400KV the high-speed X-ray photography was used to observe the compression and deformation of the liver during the direct impact of the central part of the xiphoid process in dif-ferent delay time. Results After by the compression and deformation on the abdominal cavity it restored slowly, the abdominal cavity was furthest compressed to 4.32cm （ reached abdominal thickness 65.2%）. When the abdominal cavity occurred compression and deformation,in the direction vertical to the impact ,the maximal distance of liver de-formation was 3.74 cm （compress measure is 71.3%）. Meanwhile,the deformation and displacement of the liver, heart and lungs were different. The maximal upward vertical displacement of the cardiac apex was 1.18cm. Con-clusion The main biomechanical mechanism of liver impact injury is that the energy gives directly compression to liver through the sharp compression and deformation of abdominal cavity, and makes liver severe relative shift and nonuniformity distortion. Meanwhile,the deformation and displacement of the liver, hear and lungs were different. This maybe is annexation heart and lungs injury main cause.

关 键 词：肝脏损伤 撞击伤 生物力学 

分 类 号：R642[医药卫生—外科学]