常温环境下腹部火器伤肠管穿透后猪肝脏功能和形态的变化  

Changes of hepatic morphology and function in the pigs with intestinal perforations caused by abdominal firearm wound in normal environment

作　　者：张永久[1] 刘江伟[1] 李泽信[1] 冯德元[1] 邹赛英[1] 雷涛[1] 南林[1] 梁晓莉[1] 

机构地区：[1]兰州军区乌鲁木齐总医院普外科,新疆乌鲁木齐830000

出　　处：《西北国防医学杂志》2007年第4期254-256,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：兰州军区医药卫生科研基金资助项目(LXH-2005019)

摘　　要：目的:观察常温环境下猪腹部火器伤肠管穿透后肝脏功能和形态的变化。方法:健康长白仔猪42头随机等分为对照组和伤后1、2、4、8、12和24 h组,实验组建立腹部火器伤肠管穿透模型后,分别测定伤后1、2、4、8、12和24 h各组动物血清中ALT、AST水平,并与对照组比较。对照组麻醉,但不建立火器伤模型。在光镜下观察各组肝脏组织学变化,电镜下观察肝脏超微结构改变。结果:伤后各组血清ALT、AST水平均高于对照组,并于伤后2 h和12 h出现2个高峰(P<0.01)。伤后1、2、4 h组出现逐渐加重的肝细胞水肿、变性,伤后8、12、24 h组出现逐渐加重的肝细胞点状坏死、灶状坏死、炎细胞浸润和肝细胞超微结构损伤。对照组光镜下未见明显的损伤性变化。结论:腹部火器伤肠管穿透导致肝脏出现功能和形态的损伤性变化,随着伤后时间的延长而加重。Objective： To investigate the Changes of hepatic function and morphology in pigs with abdominal firearm wound in normal environment. Methods： 42 Chang - Bai piglets were randomly divided into 7 groups： control group, 1 h group, 2 h group, 4 h group, 8 h group, 12 h group and 24 h group after wound. The model of intestinal perforations was established by abdominal firearm wound . The serum ALT and AST levels were determined. The alterations of hepatic tissue were observed under light microscope. The ultrastructural changes of liver were observed under the electron microscope. Results： The serum levels of ALT and AST in wounded groups were significantly elevated compared to the control group. Two peaks appeared in 2 h group and 12 h group （P 〈 0.01 ）. The hepatocyte edema and metamorphosis gradually aggravated from 1 h group to 4 h group. The hepatocyte spot necrosis and piecemeal necrosis was found in the 8h group, and increased from 8h group to 24 h group. The ultrastructural injuries were found under the electron microscope. Conclusion： Intestinal perforations caused by abdominal firearm wound lead to hepatic functional and morphological injuries, which aggravates with the prolongation of wound.

关 键 词：腹部火器伤 肝损伤 多器官功能衰竭 

分 类 号：R656.1[医药卫生—急诊医学]