火器伤清创药物疗效评估模型的建立与分析  

Reproduction and analysis of an animal model for assessing the efficacy of debridement agent for firearm injuries

作　　者：胡维[1] 王爱民[1] 张波[1] 刘帅[2] 张良潮[2] 王建民[2] 

机构地区：[1]第三军医大学大坪医院关节四肢外科,重庆400042 [2]第三军医大学大坪医院野战外科研究所六室,重庆400042

出　　处：《解放军医学杂志》2011年第4期401-404,共4页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金NSAF联合基金(10776038);全军“十一五”医药卫生专项课题(08Z027)

摘　　要：目的建立一种用于火器伤药物清创疗效评估的动物模型。方法兔、羊各4只分别为A、B组,猪8只,随机平均分为C、D组。采用"五三"式滑膛枪发射球形破片(枪口速度约850m/s,质量0.375g)致伤A、B、C组动物后肢软组织,相同方法发射圆柱形破片(枪口速度约950m/s,质量0.87g)致伤D组动物,观察局部伤情,进行伤道组织病理分区,检测细菌量及细胞因子水平,并分析变异系数(CV)以评价模型伤情稳定性。结果所有动物均造成后肢单纯软组织贯通伤。B、C组伤道入、出口面积和伤道容积等局部伤情指标稳定性优于A、D组。伤道组织病理学观察可见典型火器伤组织病理分区,C组伤情稳定性优于其他3组。细菌量检测显示伤道组织污染程度较重,各组间无显著差异。伤道组织内TNF-α和IL-6水平在伤后24h内呈逐渐升高趋势,血浆TNF-α和IL-6水平变化与之类似,但整体水平低。结论射速约850m/s、质量0.375g钢制球形破片所致猪后肢单纯软组织贯通伤具有典型火器伤伤道组织病理学及细菌学等特征。该模型操作方法简单,动物伤情稳定,具有良好的重复性。Objective To reproduce an animal model for assessing the efficacy of a debridement agent for firearm injuries.Methods Rabbits and goats（4 each） were assigned to group A and group B,and 8 pigs were randomly divided into group C and group D（4 each）.Spherical projectiles（initial velocity 850m/s,weight 0.375g） fired by a 53-type musket were used to produce soft tissue injuries of hind limbs in group A,B and C,and cylindrical projectiles（initial velocity 950m/s,weight 0.87g） fired by a 53-type musket were used in group D.The local traumatic condition,pathological zones,bacterial counts and cytokine levels of tissues around the wound tracks were measured,and the constancy of the model was evaluated using coefficient of variation（CV）.Results Penetrating wounds of soft tissues were made in hind limbs in all animal.The consistency degree of wound track entrance size,exit size and volume of wound track was higher in group B and D than in group A and D.Typical pathological zones of firearm wounds were observed under light microscope,and it was found that the local traumatic condition was more constant in group C than in other three groups.Determination of bacterial counts showed a heavy bacterial contamination of tissues in wound tracks,but significant difference was found among these groups.TNF-α and IL-6 levels in wound tissues increased gradually within 24 hours after the injury,and the changes in TNF-α and IL-6 levels in plasma showed a similar trend,but all the cytokine levels were low.Conclusions Simple soft tissue penetrating wounds in posterior limbs of pigs produced by spherical projectiles（velocity 850m/s,weight 0.375g） possess typical histopathological and bacterial characteristics of firearm injuries.This model is simple to reproduce,the traumatic condition is constant,and has a good reproducibility.

关 键 词：创伤 枪击 清创术 模型 动物 

分 类 号：R641[医药卫生—外科学]