猪腹部火器伤肠穿孔后细菌学及体温的变化  

Body temperature and bacteriological changes in the pigs with intestinal perforations due to abdominal firearm wound

作　　者：刘江伟[1] 张永久[1] 李泽信[1] 龙小平[2] 赵笑云 赵丽娜[2] 李广生[2] 

机构地区：[1]兰州军区乌鲁木齐总医院普外科 [2]解放军第546医院 [3]解放军第63650部队卫生处

出　　处：《西北国防医学杂志》2007年第5期331-333,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:观察腹部火器伤肠穿孔后猪体温变化和伤后细菌学的定量和定性分析为战创伤救治提供理论依据。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,实验组建立猪腹部火器伤肠管穿透伤模型后,观察各个时间点的体温变化。进行伤道分泌物的定量和定性分析以及血液的细菌培养及菌群分析。结果:伤后动物体温逐渐升高,在伤后12、24 h实验组的平均体温达40℃以上;伤后8 h,伤道的每克组织细菌数为(5.93±0.78)×105,达到感染的临界值,弹道局部渗出物中均有表面菌群,伤后4 h开始各组可检测到肠道菌群,血液菌培养阳性,可检测到表面菌群和肠道菌群。结论:腹部火器伤肠穿孔后细菌繁殖快、容易入血,体温升高明显,处理应尽早、合理地清创和早期使用广谱抗生素。Objective：To investigate the body temperature and bacteriological changes of wound tract and blood in the pigs with abdominal firearm wound. Methods： 42 Chang - Bai piglets were divided into 7 groups randomly ： 6 were wounded groups and named 1 h, 2 h, 4 h, 8 h, 12 h and 24 h group respectively, one group was not wounded and used as control. The model of intestinal perforations was established by abdominal firearm wound in wounded groups. Body temperature was measured. The quantitative and qualitative analysis of bacteria was performed in all groups. Results： Body temperature was gradually elevated from the control group to 24 h group. It was increased to higher than 40℃ in the 12 h and 24 h groups. The number of bacteria in wound tracts was （5.93±0.78）×10^5/g in the 8 h group and reached critical point of infection. The surface bacteria were found in wound tract in all wounded groups, and the intestinal flora were found from the 4 h group to 24 h group. The invasion of bacterial into blood occurred after 4 h of injury. Conclusion： The intestinal perforations due to abdominal firearm wound caused the obvious elevation of body temperature, rapid growth of bacteria and easily invasion into blood Therefore the earlier and rational debridement of the wound and the application of broad - spectrum antibiotics should be emphasized after wound.

关 键 词：腹部火器伤 肠穿孔 体温 细菌学 

分 类 号：R656.7[医药卫生—外科学]