猪腹部火器伤肠管穿透伤后继发性肺脏损伤的变化  

Changes of Lung Injury following Intestinal Perforation due to Abdominal Firearm Wound in Pigs

作　　者：高伟[1,2] 张东[2] 刘江伟[2] 薛会朝[2,3] 冯德元[2] 胡良煜[2] 邹赛英[2] 

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]兰州军区乌鲁木齐总医院肝胆外科,新疆乌鲁木齐830000 [3]新乡医学院第一附属医院普外科,河南卫辉453100

出　　处：《现代生物医学进展》2010年第2期237-239,共3页Progress in Modern Biomedicine

基　　金：兰州军区医药卫生科研基金资助项目(LXH-2005019)

摘　　要：目的:探讨腹部火器伤肠管穿透后继发性肺脏损伤及内毒素的变化规律。方法:健康长白仔猪42头随机分为对照组以及伤后1h、2h、4h、8h、12h和24h组.实验组建立腹部火器伤肠管穿透模型后,分别用显色基质鲎试剂法检测伤后1h、2h、4h、8h、12h和24h组各组动物血清中内毒素水平,并与对照组比较,观察实验组各时间点肺脏组织病理学及超微结构的变化。结果:伤后各组血浆内毒素水平用明显高于对照组(P<0.01)。伤后4h、8h、12h、24h组光镜下出现逐渐加重的肺组织内炎性细胞浸润,肺泡壁增厚,肺泡间质血管扩张充血;电镜下创伤组出现逐渐加重的线粒体肿胀、溶解;对照组光、电镜下未见明显的损伤性变化。结论:腹部火器伤肠管穿透后内毒素血症可能在继发性肺损伤中起重要作用,肺部损伤随着伤后时间的延长而逐渐加重。Objective：To investigate the changing regularity of endotoxin and changes of secondary pulmonary injury in abdominal firearm wound pigs. Methods：A total of 42 Chang-Bai piglets were randomized into 7 groups：control group and 1h group,2h group,4h group,8h group,12h group,24h group. The model of penetrating abdominal firearm wound was established in wounded groups. Levels of serum endotoxin were measured by using chromogenic limulus amebocyte lysate test. The histological change of pulmonary tissue were observed with light microscope and electron microscope（EMS） . Results：Levels of serum endotoxin in wounded groups were all significantly elevated compared to control group（P 0.01） . The 4h,8h,12h,24h experimental group appeared gradually inflammatory cell infiltrate,alveolar wall thicken,alveoli pulmonum interstitium angiectasia hyperemia under light microscop,mitochondrial appeared gradually aggravated swelling and dissolved under EMS in wound group. There were no obviously change in the injury in the control group under light microscope and EMS. Conclusion：Intestinal perforations due to abdominal firearm wound evoke endotoxemia which may play an important role in the secondary pulmonary injury and aggravated with prolongation of the wound.

关 键 词：腹部损伤 火器伤 肺脏 猪 内毒素 

分 类 号：R654.2[医药卫生—外科学]