犬肢体爆炸伤并海水浸泡后致感染的组织病理变化研究  

Early histopathological changes in explosive wounds at canine limbs following seawater immersion

作　　者：洪建明 刘敏 胡学峰 

机构地区：[1]解放军第一七一医院骨科,江西省九江市332000

出　　处：《中华创伤骨科杂志》2011年第10期956-959,共4页Chinese Journal of Orthopaedic Trauma

基　　金：南京军区医学科技创新项目（2008533）

摘　　要：目的观察犬肢体爆炸伤并海水浸泡后早期伤口感染情况及其病理特征。方法选择体质量10～15kg成年犬40只，随机分为实验组和对照组，每组20只。分别将左后肢爆炸致伤，以生理盐水冲洗、无菌敷料覆盖，实验组20只伤肢以海水浸泡1h，对照组20只木行海水浸泡。术后3d取伤口组织行病理榆查、细菌培养及药敏实验，术后统计各犬肢体伤口愈合时间；4、8周取组织病理切片观察。结果实验组与对照组2种处理方式相比较，实验组15只（75％）感染，对照组8只（40％）感染，差异有统计学意义（P〈0．05）；实验组伤口平均愈合时间为38．4d，对照组为23．1d，差异有统计学意义（P〈0．05）。实验组内弧菌属感染后组织坏死及炎件改变较杆菌属歧球菌属更严重，4、8周实验组组织坏死及炎性改变较对照组严重。结论行海水浸泡后感染组织坏死及炎性程度较未行海水浸泡要严重；且行海水浸泡后，伤口的愈合时间长。Objective To observe early histopathologieal changes in explosive wounds at canine limbs after seawater immersion. Methods Forty adult dogs, weighing 10 to 15 kg each, were assigned into 2 equal gruups. The left hind limb of each dog in both groups was injured by a man-made explosion. The explosive wound was first washed by normal sodium. The 20 injured limbs in the experimental group （EG） were immersed in seawater for one hour while those in the control group （CG） were only exposed naturally fur one hour without seawater immersion. All the wounds were covered with sterile dressing without suture. The pus and soft tissue at the wound were taken for pathological examination, bacterial culture and drug sensitivity test on day 3. The time of wound healing was recorded. Tissue sections were taken frum the wounds for pathological examination at 4 and 8 weeks. Results Fifteen wounds （75%） were infected in the EG, significantly more than the 8 wounds infected （40%） in the CG（ P 〈 0. 05）. The wounds healed in a mean time of 38.4 clays in the EG, significantly longer than the mean time for wound healing （23. 1 days） in the CG （ P 〈 0. 05）. In the EG, Vihrio infection caused more serious tissue necrosis and inflammatul7 reaction than Bacillus and coccus did. At 4 and 8 weeks, tissue necrnsis and inflammatory reaction in the EG were worse than those in the CG. Conclusion Seawater immersion can lead to increased infective tissue necrosis anti inflammatory reaction in an explosive wound, as well as longer time for wound healing.

关 键 词：海水 感染 细菌 病理变化 

分 类 号：R686[医药卫生—骨科学]