猪下肢高速三角破片伤后血生化变化与脏器损伤  

Changes of serum biochemical indexes and viscera injuries in pigs with ham wounds inflicted by high-velocity triangular fragments

作　　者：高志明[1] 周继红[1] 张岫竹[1] 张良[1] 邱俊[1] 王旭辉[1] 代维[1] 刘大维[1] 王伍超[1] 张良潮[1] 林井副[2] 王建民[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所,全军/重庆市交通医学研究所,创伤,烧伤与复合伤国家重点实验室,重庆400042 [2]解放军海军总医院影像科,北京100037

出　　处：《局解手术学杂志》2013年第4期353-356,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：NSAF联合基金(10776038);海军后勤部科研计划项目(07-3306)

摘　　要：目的探讨猪下肢高速三角破片伤后血清生化改变与脏器损伤的特点。方法长白猪12只,体质量(35.5±5.7)kg。用初速为(773.1±12.4)m/s的0.37 g三角破片弹致猪右后肢股骨外侧5 cm处火器伤。观察动物生命体征及伤道情况,于伤前、伤后1、6、24、48 h测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酐(CR)、尿素氮(BUN)、磷酸肌酸激酶(CK)、乳酸脱氢酶(LDH)含量及渗透压(OSM)值,动物于伤后48 h活杀,行脏器大体和光镜病理观察。结果伤后48 h内动物生命体征较平稳(P>0.05)。伤后1 h血清中ALT、AST、CR、BUN、CK、LDH即出现显著升高(P<0.05),并持续到伤后48 h(P<0.01);血清OSM值进行性降低(P<0.05)。大体病理解剖见66.7%的动物肺出现点片状出血、水肿或不张等,光镜下可见肺泡腔内有大量的红细胞、水肿液,肺泡壁破裂等;心、肝、肾、肠道等未见明显器质性病理损伤。结论肢体高速三角破片伤后,可引发明显的血液生化指标的改变,引起全身多种脏器的损害,其中肺是最为敏感的脏器。Objective To study the changes of serum biochemical indexes and the characteristics of the viscera injuries in pigs with ham wounds inflicted by high-velocity triangular fragments. Methods 12 landraees weighting （ 35.5 ± 5.7 ） kg were shooted by 0.37 g triangular fragments with initial velocity of （773.1± 12.4 ） m/s, aimed at 5 cm aside from the right ham lateral femur. The vital signs and information of wound tract were observed. The serum ALT, AST, CR, BUN, CK, LDH and OSM were detected at pre-injured and 1,6,24,48 h after injured. Gross anatomy and light microscope pathology of internal organs at 48 h after injured were observed. Results The vital sign of ani- mals have no significantly changes after injured（ P 〉0.05 ）. The values of serum ALT, AST ,CR ,BUN ,CK and LDH increased significantly at 1 h when the OSM step down（P 〈0.05） ,and the changes lasts 48 h after injured. In gross anatomy,66.7% lungs had patchy or punctate hemorrhage,edema or atelectasis. Pulmonary interstitial hemorrhage, edema and alveolar rupture were main pathological changes under the light microscope. No obviously organic pathological change was seen in heart, liver, kidney and intestines. Conclusion The values of serum biochemical indexes were abnormal diversity immediately after the ham inflicted with high-speed triangular fragments. Multiple internal organs were suffered and lung was the most susceptible organ in them.

关 键 词：火器伤 高速三角破片 血生化 脏器损伤 猪 

分 类 号：R642[医药卫生—外科学] R363[医药卫生—临床医学]