猪胸部枪弹伤后眼组织超声显像早期观察  

Early observation of eye remote effect of gunshot wound in chest by ultrasonography in pigs

作　　者：韩非[1] 廖明松[2] 蒋炜[1] 陶杰[2] 吴晓波[2] 何建春[3] 胡健[4] 谌阳 

机构地区：[1]成都军区总医院眼科,四川成都610083 [2]成都军区总医院超声科,四川成都610083 [3]成都军区总医院放射科,四川成都610083 [4]成都军区总医院干部病房,四川成都610083

出　　处：《西南国防医药》2008年第3期320-321,F0004,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：成都军区"十五"课题(01A011)

摘　　要：目的:探讨猪胸部枪弹伤远达效应致眼部组织结构及血流动力学改变的规律及意义,为平战时胸部枪弹伤伤病员的早期、全面救治提供参考依据。方法:采用高速弹射击10只猪(20只眼),建立胸部枪弹伤动物模型,利用超声显像技术对动物模型致伤前、后不同时相点的眼部组织结构及视网膜中央动脉血流动力学进行研究,并与眼组织病理做对照分析。结果:(1)伤后眼形态大小正常,2只眼玻璃体后脱离,4只眼玻璃体混浊,球后未见异常回声;(2)彩色多普勒血流成像显示致伤前后视网膜中央动脉血流频谱形态无变化。伤后24 h内,视网膜中央动脉的血流动力学参数有显著改变,血流速度减慢,阻力指数增高。结论:胸部枪弹伤后部分眼的二维超声显像有显著改变,视网膜中央动脉血流速度低、阻力大;高频二维超声和彩色多普勒血流成像技术为胸部枪弹伤后早期眼组织变化提供准确的参考依据,对提高临床救治水平,防治眼部并发症具有重要价值。Objective：To investigate the application of ultrasonography to early diagnosis of eye remote effect of gunshot wound in chest. Methods：The model of thoracic gunshot wound was established by rapid firing at the chest in 10 pigs （20 eyes）. The eye tissue structure, pathological changes and hemodynamics of central retinal arteries were observed and compared at different time points by means of high - frequency two - dimensional color Doppler flow imaging after the injury, Results：After the injury, the size of all eyes was normal, two cases of posterior vitreous detachment and four ones of turbid vitreous bodies were found and there were no retrobulbar abnormal echo. The color Doppler flow imaging showed that central retinal artery flow pattern.s did not change after injury. The hemodynamic parameters changed significantly within 24 hours after the injury, including slow blood flow and high resistant indexes Conclusion.After the thoradc gunshot wound, some significant changes on two - dimensional ultrasound imaging of the eyes can be observed, such as low blood flow in retina central arteries and high resistant indexes Therefore, ultrasonography can be used to evaluate eye remote effect of gunshot wound in chest.

关 键 词：胸部枪弹伤 超声 彩色多普勒血流成像 远达效应 

分 类 号：R655[医药卫生—外科学]