开放爆炸环境下烧冲复合伤动物模型建立的研究  

Establishment of an animal model with burn-blast combined injury in the open explosive environment

作　　者：刘锐 曹卫红[2] 王树明[3] 胡森[4] 李宗瑜 苏海涛 吕艺[4] 张慧萍 赵增凯[4] 郑金光 盛志勇[4] 

机构地区：[1]哈尔滨市第五医院烧伤科,150040 [2]空军总医院烧伤整形科,北京100142 [3]空军总医院呼吸科,北京100142 [4]解放军总医院附属第一医院烧伤研究所,北京100048

出　　处：《中华损伤与修复杂志（电子版）》2014年第6期17-23,共7页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：全军"十二五"后勤科研计划课题资助项目(CKJ12J027)

摘　　要：目的建立理想的开放爆炸环境下烧冲复合伤动物模型。方法以Wistar雌性清洁级成年大鼠460只为研究对象。随机选取90只大鼠设为预实验组,其余370只大鼠随机选取360只大鼠设为实验组,剩余10只大鼠设为正常对照组。预实验组90只大鼠随机分为预单纯烧伤组(n=30),预烧冲复合伤组(n=30),预烧冲复合伤组(n=30);预单纯烧伤组采用凝固汽油涂抹背部点燃25 s造成深Ⅱ度烧伤,烧伤面积分别为10%总体表面积(TBSA)(轻度,n=10)、25%TBSA(中度,n=10)、40%TBSA(重度,n=10);预单纯冲击伤组采用柱形黑索金炸药在不同距离(70、50、30 cm)造成轻度、中度、重度冲击伤(每组n=10);按照预单纯烧伤组及预单纯冲击伤组动物死亡率及器官功能障碍等,确定轻度、中度、重度的预烧冲复合伤模型:预轻度烧冲复合伤(轻度烧伤+轻度冲击伤),预中度烧冲复合伤(中度烧伤+中度冲击伤),预重度烧冲复合伤(重度烧伤+重度冲击伤);观察伤后24 h大鼠宏观变化及死亡率。实验组370只大鼠随机分为单纯烧伤组(n=120,其中轻、中、重3组,每组n=40),单纯冲击伤组(n=120,其中轻、中、重3组,每组n=40),烧冲复合伤组(n=120,其中轻、中、重3组,每组n=40),正常对照组(n=10),模型的建立同预实验,伤后6 h、1 d、2 d、3 d用自动生化仪检测实验组大鼠血清肌酸激酶同工酶(CK-MB)、谷丙转氨酶(GPT)、血肌酐(Scr),并同时观察实验组大鼠死亡率及用光学显微镜观察各脏器病理变化。结果预轻、中、重度冲击伤组大鼠伤后24 h死亡率分别为10%、30%、100%;预轻、中、重度烧伤组大鼠伤后24 h死亡率分别为10%、20%、40%;预轻、中、重度烧冲复合伤组大鼠伤后24 h死亡率分别为20%、30%、100%;预冲击伤组:预重度冲击伤组大鼠均可见骨膜穿孔,均有球结膜出血,9例可见口腔黏膜破溃出血。预中度冲击伤组大鼠仅1例出现可见骨膜穿孔,9例出现球结膜出血,5例可Objective To establish an animal model of burn-blast combined injury in the open explosive environment.Methods All 460 female Wistar rats were involved in this study.Ninty rats were randomly divided into pre-experiment group,the other 370 rats were randomly selected 360 rats as the experiment group,10 rats were divided into normal control group.The rats in pre-experiment group were randomly divided into pre-burn group（n=30）,pre-blast injury group（n=30）,pre-burn-blast combined injury group（n=30）,rats in pre-burn group were burned with napalm smear on back for 25 seconds in order to replicate deep partial thickness burn,the TBSA of burned area was 10%（n=10）,25%（n=10）, and 40%（n=10）.The column explosives RDX was used in pre-blast injury group at different distance in order to replicate mild,moderate,severe blast injury.The models of the mild,moderate,severe pre-burn-blast combined injury were replicated according to the mortality and incidence of multiple organ dysfunction in pre-burn group and pre-blast injury group.Mild pre-burn-blast combined injury was combined with mild burn and mild blast injury,moderate pre-burn-blast combined injury was combined with moderate burn and moderate blast injury,severe pre-burn -blast combined injury was combined with severe burn and severe blast injury.The mortality rate and macroscopic changes were observed 24 hours after injury.Three hundred and seventy rats in experiment group were randomly divided into burn group（n=120,the mild,moderate, severe in 3 groups）,blast injury group （n =120,the mild,moderate,severe in 3 groups）,burn-blast combined injury group（n=120,the mild,moderate,severe in 3 groups）,and control group（n=10）.The establishment of the model was the same with pre-experiment. The mortality,serum creatine kinase isoenzyme （CK-MB）,alanine aminotransferase（GPT）,serum creatinine （Scr）and the changes pathology were observed in experiment group in 6 h,1 d,2 d,3 d after injury.Results The mortality in mild, moderate,severe

关 键 词：烧冲复合伤 模型 动物 多器官功能衰竭 大鼠 

分 类 号：R644[医药卫生—外科学] R-332[医药卫生—临床医学]