山羊重度原发性肺冲击伤模型的建立  

Study on severe blast lung injury mode of goats

作　　者：邵世锋 程祥云 李琦 曾琳 张良潮 雷洋 伍正彬 段朝霞 王耀丽 王建民 Shao Shifeng;Cheng Xiangyun;Li Qi;Zeng Lin;Zhang Liangchao;Lei Yang;Wu Zhengbin;Duan Chaoxia;Wang Yaoli;Wang Jianmin(Wound Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing 400042, China;Department of Weapon Injury Bioeffect Assessment, Army Medical University, Chongqing 400042, China;Respiratory and Critical Care Medicine Center, Xinqiao Hospital, Army Medical University, Chongqing 400037, China;Department of Field Medical Equipment, Army Medical University, Chongqing 400042, China)

机构地区：[1]陆军(第三)军医大学第三附属医院战创伤医学中心创伤、烧伤与复合伤国家重点实验,重庆400042 [2]武器杀伤生物效应评估研究室,陆军特色医学中心,重庆400042 [3]陆军(第三)军医大学第二附属医院呼吸与危重症医学中心,重庆400037 [4]野战卫生装备与器材研究室,陆军特色医学中心,重庆400042

出　　处：《中华肺部疾病杂志（电子版）》2021年第6期723-728,共6页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：高原新型爆炸武器伤特点及早期救治关键技术(ALJ18J001);重庆市医学重点专科建设项目。

摘　　要：目的建立山羊重度原发性肺冲击伤模型,为重度原发性肺冲击伤的特点和院前救治提供实验基础。方法致伤驱动压初筛:选取山羊20只,随机分为4组(3 m组4只,4 m组7只,5 m组5只,6 m组4只),采用8 kg TNT当量新型爆炸物,以相同的环境条件下致伤,对比4组肺冲击伤伤情,分别于伤前、伤后0.5 h、3 h、6 h、24 h观测动物生命体征和血气分析、肺大体解剖测定肺组织含水量等,并对重伤山羊进行院前ABC救治。结果3 m伤后15 min内死亡1只,4 m伤后颈内动脉穿刺置管后即刻死亡1只,4 m伤后24 h内死亡1只,其余4组动物均存活。重度原发性肺冲击伤伤情特点观察,伤后即刻出现持续呼吸窘迫、气道分泌物增多,动物心率加快。伤后15 min死亡山羊肺大体解剖出现广泛点片状出血和水肿,肺含水量显著增加,为重度冲击伤,AIS评分4分,肺内可见血栓性支气管树,气道内大量粉红色泡沫痰。重型原发性肺冲击伤肺出血、肺水肿严重,院前环甲膜切开、气管插管呼吸机辅助通气等常规救治难以逆转而死亡。结论8 kg TNT当量爆炸物在3 m距离下,可建立山羊重度原发性肺冲击伤模型,此模型伤情稳定,可用于原发性肺冲击伤机制和院前救治的实验研究模型。常规气管插管接呼吸机辅助通气模式的治疗措施难以逆转重度原发性肺冲击伤。Objective To establish an animal model of severe blast lung injury in goats,and to provide a way to study the characteristic and pre-hospital treatment of blast lung injury.Methods Randomly selected twenty goats and divided them into four groups(4 goats in the 3 m group,7 goats in the 4 m group,5 goats in the 5 m group and 4 goats in the 6 m group),and the blast lung injuries were made by 8 kg TNT-equivalency new explosive.Observed the vital signs,blood gas analysis,physiological index,gross anatomy of the lung,pathology,and lung tissue water content at the time of injury immediately(0 hour),0.5 hours,3 hours,6 hours,24 hours after the injury respectively.Pre-hospital ABC was performed on the severe injured goats.Result One died within 15 minutes after a 3-meter injury,one died immediately after the internal carotid artery puncture and catheterization after a 4-meter injury,and one died within 24 hours after a 4-meter injury.The remaining 4 groups of animals all survived.Severe primary lung impact injury in goats is characterized by continuous respiratory distress,increased airway secretions,and increased animal heart rate immediately after the injury.The goat died 15 minutes after the injury.There were extensive spotted hemorrhage and edema on the general anatomy of the lung.The lung water content increased significantly.It was a severe impact injury.The AIS score was 4 points.There were thrombotic bronchial trees in the lungs and a lot of pink foamy sputum in the airways.Pulmonary hemorrhage and pulmonary edema were severe due to severe primary pulmonary impact injury.Routine treatments such as pre-hospital cricothyrotomy and tracheal intubation ventilator assisted ventilation were difficult to reverse,then died.Conclusion An 8 kg TNT-equivalency explosive established a goat′s severe primary lung injury model at a distance of 3 meters.This model was stable and could be used as an experimental research model for the mechanism of primary blast lung injury and pre-hospital treatment.Conventional tracheal intubat

关 键 词：肺冲击伤 山羊 动物模型 新型爆炸物 

分 类 号：R563[医药卫生—呼吸系统]