手枪弹击中防弹头盔致颅脑损伤特点的实验研究  

Experimental study on characteristics of craniocerebral injury caused by handgun bullet impacting on bulletproof helmet

作　　者：黄艺峰[1] 许民辉[1] 赖西南 王丽丽 张波 苏正林[1] 陈魁君 李冠桦 

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

出　　处：《中华创伤杂志》2011年第10期953-956,共4页Chinese Journal of Trauma

基　　金：国防“973”资助项目（613104）

摘　　要：目的观察手枪弹击中防弹头盔致颅脑损伤的特点。方法将14只健康长白猪随机数字表法分为致伤组（9只）和对照组（5只）。致伤组使用9mm手枪弹、360m／s射速垂直射击防弹头盔板防护下的猪头部；对照组除使用相同弹药量无弹头手枪弹射击外，余同致伤组。观察伤后早期生命体征变化及伤后2h视网膜损伤『青况。留取伤前、伤后3h脑脊液，用以检测脑损伤标志物神经元特异性烯醇化酶（neuron specific enolase，NSE）和αⅡ-spectrin蛋白的含量。随后处死动物并解剖，观察颅脑大体形态改变，取部分脑皮质固定、HE染色，观察其显微病理改变。结果致伤组伤后早期出现血压下降，心率和呼吸频率加快。大体观察示视网膜出血（3／9）。颅骨骨折（3／9），脑表面损伤，包括局部脑撞击伤（9／9）及对冲伤（9／9），撞击伤重于对冲伤。显微镜下见撞击部位及对冲部位大脑皮质神经元急性损伤，伤后3h脑脊液NSE、αⅡ-spectrin蛋白含量较伤前显著升高（P〈0．05）。结论手枪弹击中防弹头盔板防护下的猪头部早期可致钝性颅脑损伤，且撞击伤重于对冲伤。因此，作战人员防弹头盔后颅脑损伤应引起重视，并早期诊断和治疗。Objective To study the characteristics of craniocerebral injury caused by the handgun bullet impacting on the bulletproof helmet. Methods Fourteen healthy landrace pigs were involved and randomly divided into injury group （n = 9） and control group （n = 5 ）. The landrace pigs of the injury group were shot vertically on the head under the protection of helmet plate with 9 mm handgun bullet at velocity of 360 m/s. While the landrace pigs of the control group were dealt with the same process as the injury group except for use of unarmed handgun bullet of the same ammunition dose. The changes of vital sign in the early period and the retina injury at two hours after injury were observed. Porcine cerebrospinal fluid （CSF） at pre-injury and at three hours post-injury were obtained for investigating the levels of neuron specific enolase （NSE） andαⅡ-spectrin protein. Then, the landrace pigs were sacrificed and dissected to examine the general morphological changes of the brain. The brain cortex was taken, fixed and stained with hematoxylin-eosin for microscopic observation. Results The landrace pigs in the injury group manifested decrease of the blood pressure and increase of the heart rate and respiratory rate in the early stage after injury. General morphological observation found retinal hemorrhage （3/9）, skull fracture （3/9） and brain surface damage including local impact lesion （9/9） and contrecoup lesion （9/9）, with severe impact lesion than contrecoup lesion. Optical microscopic observation revealed acute injury of the cerebral cortex neuron both on the impact and contrecoup locations. The concentrations of NSE and αⅡ-spectrinwere significantly increased in CSF three hours after injury （P 〈 O. 05）. Conclusions The handgun bullet impacts on the pig head protected by the bulletproof helmet may induce blunt craniocerebral injury in the early period, with severe impact lesion than contrecoup lesion. Therefore, traumatic brain injury of the soldiers armed with the helmets shou

关 键 词：脑损伤 挫伤 头部防护装置 枪击 

分 类 号：D9[政治法律—法学]