封闭负压引流对猪肢体枪弹软组织贯通伤初期治疗实验研究  

Vacuum sealing drainage for penetrating gunshot wounds in porcine extremities

作　　者：李荣刚[1] 刘兴炎[2] 陈克明[2] 葛宝丰[2] 程瑞萍[2] 彭俊华[2] 叶建军[2] 熊发明[1] 梁建平[1] 

机构地区：[1]兰州大学第二临床医学院,730050 [2]兰州军区兰州总医院骨科中心,730053

出　　处：《实用医学杂志》2010年第9期1515-1518,共4页The Journal of Practical Medicine

基　　金：全军"十一五"重点课题(编号:06G033)

摘　　要：目的:观察封闭负压引流(VSD)对猪肢体枪弹软组织贯通伤初期治疗的效果,为临床枪弹伤早期救治提供理论依据。方法:选取兰州地区健康成年长白约克品种猪8只,用95式步枪射击致双后肢贯通伤,距离25m。致伤后将两双后肢自体左右配对,分成VSD组和对照组。两组致伤6h行弹道清创消毒。分别在致伤后不同时间作细菌学计数,行病理学检查,5、72h行彩色多普勒超声检查。结果:治疗后细菌学计数两组比较差异有显著性(P<0.05),病理学VSD组较对照组肉芽组织丰富,且炎细胞浸润、肌组织溶解变性及弹道表面菌落不明显。72h超声检查VSD组较对照组弹道及周边红蓝血流信号丰富,并见断裂肌束逐渐恢复。结论:VSD可降低枪弹软组织贯通伤细菌数量延缓感染时间、促进肉芽组织生长及局部血流量、减少创周组织水肿及降低血管通透性。Objective To investigate the efficacy of vacuum sealing drainage （VSD） for penetrating gunshot wounds in porcine extremities, and to provide theoretical support for early treatment of gunshot wounds. Methods 8 healthy adult Landrace pigs were included in this study. Both hind legs of the pigs were shot by a 95 rifle （25 meters away） to make penetrating wounds. The two hind legs were then divided into VSD group and control group. Wound debridement and sterilization were performed six hours after gunshot. Bacterial counts and pathological examination were performed at different time points, so was color Doppler ultrasound 5 and 72 hours after gunshot. Results There was significant difference in bacterial count between the two groups （P 〈 0.05）. As compared with the control group at all time points, granulation tissue was rich but inflammatory cell infiltration, dissolution of muscular tissue, and bacterial colonies on the wound surface were not obvious in VSD group. In VSD group, the red and blue blood flow signals of the wound and its surrounding tissue were richer on ultrasonic examination, and the broken muscle bundles were gradually restored. Conclusions Vacuum sealing drainage can significantly delay the time of infection by reducing the bacterial number in the penetrating wound, accelerate the growth of granulation tissue and the local blood flow volume, and decrease local vascular permeability and tissue edema.

关 键 词：枪弹伤 封闭负压引流 动物研究 

分 类 号：R82[医药卫生—临床医学]