模拟实战条件下的爆炸伤情分析及脊髓损伤的研究  

Analysis of blast injury and spinal cord injury in simulated modern battlefield

作　　者：叶正旭[1] 李静[2] 陈永斌[3] 任冬青[3] 刘旭东[4] 王宇清[1] 黄景辉[1] 胡学昱[1] 罗卓荆[1] 

机构地区：[1]第四军医大学西京医院全军骨科研究所,陕西西安710032 [2]第四军医大学放射医学教研室,陕西西安710032 [3]第四军医大学基础部病理学教研室,陕西西安710032 [4]解放军第一医院骨神经外科

出　　处：《西北国防医学杂志》2009年第6期411-413,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：军队"十一五"科技攻关计划资助项目(06G097)

摘　　要：目的:探讨模拟实战条件下的动物爆炸冲击性损伤及脊髓爆炸冲击后的病理变化。方法:采用60 kg TNT当量的温压弹在1∶1军舰船舱模型内引爆后,现场尸检分析动物的致死原因,利用组织病理切片技术和透射电子显微镜技术观察脊髓的爆炸冲击损伤的病理特征。结果:爆炸后实验动物大部分死亡,暂时存活的动物也在1 h内死亡;动物的冲击损伤的死亡原因主要是体内重要脏器的挫裂伤;单纯脊髓冲击损伤,可以损伤脊髓内血管而造成脊髓出血、缺血性损伤;病理切片和电镜照片显示:脊髓损伤主要是白质结构的异常,水肿及脱髓鞘改变,以及神经元细胞核浓聚、偏位甚至破裂。结论:爆炸冲击性损伤多由于脏器伤情严重而掩盖了脊髓损伤的表现,脊髓爆炸冲击损伤是战伤中不可忽视的部分。Objective：To investigate the pathological changes of spinal cord after blast injury in simulated battlefield.Methods：60 kg TNT thermobaric weaponry was exploded in a 1：1 model of military ship cabin.The experimental animals were examined immediately to analyze the mechanism of death.Light microscope and transmission electron microscope were used to observe the pathological changes of spinal cord.Results：Most experimental animals instantly died after explosion,the survivals also died within 1 hour.The main cause of death was severe contusion and bleeding of the important organs.Bleeding and ischemia in spinal cord were observed.Pathological observation showed swelling,myelinolysis,stagnant blood or thrombopoiesis in the blood vessel of spinal cord,and the substantia alba was in disorder.The condensing nucleus,dissymmetry and rupture of neurons were also found.Conclusion：Spinal cord injuries are prone to be covered by severe multi-organ traumas,which should be cared as an important part of the blast injuries in battlefield.

关 键 词：爆炸伤 脊髓 病理变化 

分 类 号：R826.5[医药卫生—临床医学]