不同水深地雷爆炸对脊髓损伤特点及机制研究  

A Study on Characteristics and Mechanism of Spinal Cord Injuries Induced by Different Water Depths of Mine Explosion

作　　者：张成生[1] 张志龙[2] 马骁[1] 王鹏[1] 刘成[1] 韩庚奋 ZHANG Cheng-sheng;ZHANG Zhi-long;MA Xiao;WANG Peng;LIU Cheng;HAN Geng-fen(Department of Orthopaedics,969 Hospital of PLA Joint Logistics Support Forces,Hohhot 010051,China;Department of General Surgery,969 Hospital of PLA Joint Logistics Support Forces,Hohhot 010051,China)

机构地区：[1]中国人民解放军联勤保障部队第九六九医院骨科,呼和浩特010051 [2]中国人民解放军联勤保障部队第九六九医院外科,呼和浩特010051

出　　处：《解放军医药杂志》2020年第2期102-107,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：内蒙古自治区自然科学基金资助(2017MS0823)

摘　　要：目的研究不同水深触雷爆炸时脊髓损伤的特点和机制,为两栖登陆作战触雷爆炸伤的救治和防护提供依据。方法64只新西兰大白兔随机分为对照组、陆地组、浅水组和深水组,每组16只。雷管爆炸致伤后取出动物脊髓切片染色,比较各组脊髓胶质纤维酸性蛋白(GFAP)含量和伤后3、6和12 h动脉血清神经元特异性烯醇酶(NSE)和髓磷脂碱性蛋白(MPB)表达水平。测试陆地组、浅水组和深水组新西兰大白兔第3腰椎椎管内冲击波压力峰值和椎体加速度峰值。结果浅水组脊髓多发蛛网膜下腔出血发生率为43.75%,深水组水平面附近脊髓挫伤发生率37.50%和神经根点状出血发生率62.50%。深水组和浅水组伤后3、6、12 h的GFAP、NSE和MPB均较陆地组表达显著增强(P<0.05)。深水组起爆后形成水泡,56 ms后冲出水面;浅水组在起爆后2 ms爆炸气体直接冲出水平面,形成水柱。深水组椎管内压力峰值均高于浅水组及陆地组(P<0.05);深水组和浅水组的椎体加速度峰值高于陆地组(P<0.05)。结论浅滩地雷爆炸会导致严重的脊髓损伤,不同水深的地雷爆炸损伤机制不同,伤情特点也不同。Objective To study characteristics and mechanism of spinal cord injuries induced by different water depth of mine explosion in order to provide basis for treatment and protection of explosion injury induced by mine explosion during amphibious landing war.Methods A total of 64 New Zealand white rabbits were randomly divided into control group,land group,shallow water group and deep water group(n=16 in each group).Spinal cord sections were taken out and stained after injuries by detonator explosion.Content of glial fibrillary acidic protein(GFAP)protein in spinal cord and expressions of neuron-specific enolase(NSE)and myelin basic protein(MPB)in arterial serum at 3,6 and 12 h after injury were compared.Peak values of shock wave pressure and vertebral acceleration in the third lumbar spinal canal of New Zealand white rabbits were detected in land group,shallow water group and deep water group.Results Incidence rate of multiple subarachnoid hemorrhage of spinal cord was 43.8%in shallow water group.Incidence rates of spinal contusion near water level and punctate hemorrhage of nerve root were 37.5%and 62.5%respectively in deep water group.Expressions of GFAP,NSE and MPB at 3,6 and 12 h after injury in deep and shallow water groups were significantly higher than those in land group(P<0.05).In deep water group,bubbles formed after explosion initiation,and burst out of the water surface at 56 ms later.In shallow water group,explosion gas burst out of the water surface directly at 2 ms later,and formed a water column.Peak value of vertebral pressure in deep water group was significantly higher than that in shallow water and land groups(P<0.05).Peak values of vertebral acceleration in deep water and shallow water groups were significantly higher than that in land group(P<0.05).Conclusion Shallow beach mine explosion may lead to serious spinal cord injury.Mechanisms of mine explosion injury by different water depths are different,and the characteristics of injuries are also different.

关 键 词：脊髓损伤 浅滩 地雷 生物力学 神经元特异性烯醇酶 髓磷脂碱性蛋白质类 兔 

分 类 号：R826.1[医药卫生—临床医学] R-332