兔胸部爆炸伤后血液高凝状态的实验研究  

Study on blood hypercoagulability after explosive injury of chest in rabbits

作　　者：初向阳[1] 侯晓彬[1] 张连斌[1] 薛志强[1] 马克峰[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《创伤外科杂志》2010年第2期165-168,共4页Journal of Traumatic Surgery

摘　　要：目的通过对兔胸部爆炸伤后血液流变学变化规律的研究,探讨伤后血液高凝状态对肺脏等脏器功能的影响。方法健康中国家兔随机分为对照组和伤后5、30分钟、1、3、6小时5个时相点致伤组,观察血液流变学及肺组织病理学动态变化。结果兔胸部爆炸伤后5分钟全血黏度、血浆黏度、红细胞聚集指数、血浆纤维蛋白原含量及红细胞变形性均低于正常对照组,30分钟以后上述指标明显升高,3小时后达峰值,与正常对照组相比有非常显著统计学意义(P<0.01),伤后6小时虽有所下降,但仍高于正常对照组(P<0.05);肺组织病理学变化与血液流变学变化基本一致。结论兔胸部爆炸伤后血液流变学特性明显改变,出现血液高凝状态,血液黏滞性显著增加,从而加重微循环障碍而导致脏器功能损伤。Objective To investigate the changes of hemorrheologie characteristics and discuss blood hyper- coagulability and its significance for pulmonary function in rabbits following explosive injury of chest. Methods Rabbits were subjected to chest explosive injury. They were randomly divided into control group and injury group. The injury group was further divided into five groups according to the duration time after injury. Hemorrheologic characteristics was examined by viscometer R80. And histologie changes of the lung were examined at 1/12,0.5,1, 3,6 hours after injury. Results Five minutes after explosive injury i the whole blood viscosity, the plasma viscosity, the index of erythroeyte aggregation,plasma fibrinogen content and the index of erythrocyte deformability decreased compared with the control group, but increased after 30 minutes and reached maximum at 3 hours after injury（ P 〈 0. 01）. The whole blood viscosity, the plasma viscosity, the index of erythroeyte aggregation and plasma fibrinogen content were lower 6 hours after injury but still higher than that of control group （ P 〈 0.05 }. Hemorrheologic char- acteristics was correlated with the severity of lung injury. Conclusion The hemorrheologic characteristics change significantly after explosive injury of chest, and blood hypereoagulability may cause damage to mierocirculation and lead to dysfuntion of one or more organs, even MSOF.

关 键 词：爆炸伤 胸部损伤 高凝状态 微循环 

分 类 号：R641[医药卫生—外科学] R655[医药卫生—临床医学]