枪弹射击致防弹衣后长白猪远达脑组织损伤特点及其机制  

Characteristics and mechanism of behind armour blunt trauma in Landrace brain

作　　者：苏正林[1,2] 许民辉[1] 赖西南 张波[2] 黄艺峰[1] 王丽丽[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经外科,重庆400042 [2]第三军医大学大坪医院野战外科研究所第六研究室创伤、烧伤与复合伤国家重点实验室,重庆400042

出　　处：《第三军医大学学报》2011年第19期1995-1999,共5页Journal of Third Military Medical University

基　　金：全军医学科研“十一五”计划专项课题(06Z034)~~

摘　　要：目的观察防弹衣后远达脑组织的损伤特点及探讨损伤的生物力学机制。方法 18只雄性长白猪分成假致伤组(n=4),子弹速度910 m/s组(n=6),740 m/s组(n=4)和590 m/s组(n=4)。致伤模型为麻醉后长白猪右侧卧位,胸前包裹外层为防护等级NIJⅢ级陶瓷硬式防弹衣,内层为警用Ⅱ级超高分子聚乙烯软式防弹衣,小口径弹道枪以25 m射距、3种不同弹速瞄准左锁骨中线4、5肋间(心脏窗)射击,假致伤组行空爆弹射击。持续监测致伤前后脑电图、心电图、有创动脉血压、心率、呼吸变化。取伤前,伤后1、2、3 h血浆进行脑损伤标志物检测,伤前及伤后3 h脑脊液进行特异性脑损伤蛋白检测。伤后3 h深麻醉后放血处死动物,取脑组织进行病理检查。另取4只雄性长白猪行生物力学测试,在上述模型基础上于弹着点心前区皮下、心包腔、左侧胸腔、左侧颈总动脉及颅内布放压力传感器,心前区锁骨中线第6肋骨布放加速度传感器及力传感器,测试命中时各部位生物力学参数及持续时间,进行分析。结果 3种不同速度组致伤后2 min内脑电图低频Delta、Theta波定量分析频谱强度幅值与致伤前比较明显降低(P<0.05),降幅约10%,伤后5 min后回升恢复到伤前水平,3种速度组间无显著差异(P>0.05)。伤后3 h光镜下尼氏染色海马存在急性损伤改变,910 m/s组海马神经元胞体萎缩,细胞核大小不等;740 m/s组神经元胞体萎缩,细胞核偏位;590 m/s组神经元轻度肿胀,损伤分级910 m/s组>740 m/s组>590 m/s组>假致伤组。3种速度子弹击中心前区防弹衣时心包腔、胸腔、颈内动脉及颅内压力瞬间急速上升,590 m/s组(23.32±4.41)kPa,740 m/s组(45.52±27.38)kPa,910 m/s组(88.27±8.81)kPa,两两比较3组压力有显著差异(P<0.01)。在外层NIJⅢ内层为警用Ⅱ级防护下,随着子弹速度的增加,长白猪出现中枢神经脑电抑制,在海马区出现中枢神经元变性、脱髓鞘改变,可能产Objective To study the characteristics of behind armor blunt trauma extending to the brain and to investigate the biomechanics mechanism of the remote injury.Methods Eighteen male Landraces were randomly divided into a sham injury group（n=4）,a bullet velocity 910 m/s group（n=6）,a 740 m/s group（n=4） and a 590 m/s group（n=4）.The injury model was anesthetized Landrace in right lateral position and wrapped in a two-layer bullet-proof vest.The outer layer was ceramic hard armor with NIJ III protection grade.The inner layer was police grade II ultra-high molecular polyethylene soft body armor.Caliber 5.8 mm ballistic guns were fired at 25 m range and three different projectile velocities,aimed at the left midclavicular line 4,5 intercostal（heart window）.Air bomb shooting was applied to sham injury group.EEG,ECG,invasive arterial blood pressure,heart rate and respiratory changes before and after injury were continuously monitored.Plasma was collected at 1,2 and 3 h before and after injury to detect markers of brain injury.Lumbar puncture was taken at 3 h before and after injury to test specific brain injury protein in cerebrospinal fluid.In 3 h after injury the animals were deep anesthetized and bled to death.Their brain blocks were collected for toluidine blue staining and electron microscopy.The other 4 Landrace pigs were used for biomechanical testing.On the basis of the above model pressure sensors were placed in the subcutaneous layer of precordium at the point of impact,pericardial cavity,left chest,left common carotid artery and cranial cavity.Acceleration sensors and force sensors were placed in the sixth rib at precordial midclavicular line.When the target was hit,each part＇s biomechanical parameters and duration were recorded and analyzed.Results In the 3 groups of different speed,spectrum intensity of low-frequency EEG Delta and Theta wave within 2 minutes after injury was significantly lower than that before injury（P0.05）,and the decline was about 10%.In 5 min after injury the ampli

关 键 词：防弹衣后钝性损伤 脑损伤 脑电图 生物力学 

分 类 号：R826.5[医药卫生—临床医学] R651.15