家兔骨盆冲击破片伤模型的建立和早期伤情特点观察  

Establishment of a Model of Pelvic Impact Fragment Injury and Observation of Early Injury Characteristics in Rabbits

作　　者：叶钊 钟鑫 贾益君 杜文琼 周小林 王浩越 蒋仁庆 宗兆文 YE Zhao;ZHONG Xin;JIA Yijun;DU Wenqiong;ZHOU Xiaolin;WANG Haoyue;JIANG Renqing;ZONG Zhaowen(Department of Combat Casualty Care Training,Training Base for Army Health Service,Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学陆军卫勤训练基地战救技能训练教研室,重庆400038 [2]陆军军医大学第二附属医院放射科

出　　处：《华南国防医学杂志》2022年第4期241-247,共7页Military Medical Journal of South China

基　　金：“十三五”后勤科研重大项目(ALJ19J001);陆军军医大学临床技术创新培育项目(CX2019JS107);新桥医院临床重大创新特色技术项目(2018JSLC0023)。

摘　　要：目的建立家兔骨盆冲击破片伤模型,并观察其早期伤情特点。方法多功能致伤机器在冲击波压强为10kPa和1个模拟破片条件下致伤。伤后给予填塞包扎及有创血压监测,并在致伤前,伤后5min、30min、1h、2h、3h、6h和12h等时相点采血检测血常规、动脉血气和血栓弹力图。影像学和尸检检查损伤情况。结果致伤后可见严重骨盆骨折伴有多发脏器损伤,伤后5min后出现严重休克,伴有碱剩余、纤维蛋白原浓度、红细胞和血小板计数降低。伤后3h内死亡率达36%。凝血系统呈现动态紊乱:凝血反应时间(R)值在致伤后5min内迅速缩短至(5.67±1.63)min,逐渐延长并在致伤后1h延长至(7.60±3.30)min,再次缩短(P<0.05);凝血形成时间(K)值和血栓最大振幅(MA)值各时相点比较差异无统计学意义(P>0.05)。结论成功地建立家兔骨盆冲击破片伤模型,其早期伤情重且变化快,需要采用综合性复苏策略。Objective To establish a model of pelvic impact fragment injury in rabbits and observe its early injury characteristics.Methods Multifunctional injury machine was used to cause injury under shock wave pressure of 10 kPa and 1 simulated fragment.After the injury,patients were given packing and bandaging and invasive blood pressure monitoring.Blood samples were collected before and 5 min,30 min,1 h,2 h,3 h,6 h,12 h and so on after the injury,and blood routine,arterial blood gas and thromboelastic diagram were detected.Radiology and autopsy were performed to examine injuries.Results Severe pelvic fractures with multiple organ injuries were developed after injury,and severe shock occurred 5 min after injury,which accompanied by decreased base excess,fibrinogen concentration,red blood count and platelet counts.The mortality rate within 3 hours after injury was 36%.The coagulation system showed dynamic disorder:The R value was rapidly shortened to(5.67±1.63)min within 5 min after injury,and then gradually extended to(7.60±3.30)min at 1 min after injury,and then decreased again(P<0.05);the K value and MA value were not statistical difference(P>0.05).Conclusion The model of pelvic impact fragment injury in rabbits has been successfully established.The early injury is severe and varied rapidly,and comprehensive resuscitation strategy is needed.

关 键 词：骨盆骨折 战伤 动物模型 伤情特点 

分 类 号：R826[医药卫生—临床医学]