抗生素在海上环境下海战伤中的应用  

Application of Antibiotic on Sea Warfare Wound in Marine Environment

作　　者：张贞良[1] 贺顺龙[2] 谢培增[2] 汪先兵[2] 

机构地区：[1]解放军421医院药剂科,广东广州510318 [2]解放军421医院神经外科,广东广州510318

出　　处：《华南国防医学杂志》2011年第6期500-502,共3页Military Medical Journal of South China

基　　金：全军医学科学技术"十一五"课题(06MB174)

摘　　要：目的探讨抗生素在海上环境下海战伤中的有效应用。方法选取40只成年杂种犬,制作海上环境下海水浸泡复合火器伤动物模型。随机将动物分成对照组和治疗组,每组20只犬。对照组采用头孢地嗪治疗,治疗组头孢地嗪加左氧氟沙星治疗。海战伤的其他处理方法相同。在伤后第2和第4天进行细菌培养与药敏试验,观察6天伤口感染率、死亡率。结果伤后6天,对照组的伤口感染率为50%,治疗组为10%;伤后6天,对照组死亡率为60%,治疗组为20%;治疗组的伤口感染率和死亡率均低于对照组(P<0.01)。治疗组弧菌构成比低于对照组(P<0.01)。结论我国南海海水中细菌种类多、分布广,主要是弧菌科细菌、金黄色葡萄球菌和肠埃希菌,也是导致海战伤感染的主要细菌。对在海上环境下处理海战伤更应强调尽早、合理的清创和早期使用广谱和抗弧菌抗生素。Objective To study an appropriate anti-inflammation treatment strategy on sea warfare wound in marine environment.Methods Animal model of combined sea warfare wound in marine environment was established in 40 mongrel dogs.The dogs were randomly divided into control group and treatment group.The control group accepted routine cefodizime treatment,and the treatment group accepted cefodizime plus levofloxacin treatment.The treatment on sea warfare wound was the same in both groups.The gross condition was observed and bacteriological strains in the wound were cultured and antibiotic sensitivity was tested at 2 and 4 days after the wound.Wound infection rate and mortality were observed at the sixth day.Results The infection rate within six days was 50% in the control group,and 10% in treatment group,and the mortality was 60% and 20% respectively.These rates were significantly lower in the treatment group than those in the control group（P0.01）.The constituent ratio of vibrion in the treatment group was lower than that in the control group（P0.01）.Conclusion There are many species of bacteria with wide distribution in South China Sea which mainly includes vibrionaceaes,staphylococcus and escherichia.These bacteria are the main causes leading to sea warfare wound infection.To deal with the sea warfare wound in marine environment,the early and complete debridement,and the early application of broadspectrum and anti-vibrion antibiotics should be emphasized.

关 键 词：海战伤 海水浸泡 细菌 抗生素 

分 类 号：R821.1[医药卫生—临床医学]