大鼠密闭管道内爆炸烧冲复合伤及重要器官损伤的观察研究  

Burn-blast combined injury and important organ injury in rats induced by explosion in closed pipe:an observation study

作　　者：翁昌梅[1] 杨光明[1] 张双博 朱英国 程祥云 段朝霞[1] 康建毅[1] 王建民[1] WENG Changmei;YANG Guangming;ZHANG Shuangbo;ZHU Yingguo;CHENG Xiangyun;DUAN Zhaoxia;KANG Jianyi;WANG Jianmin(Department of Weapon Bioeffect Assessment,State key Laboratory of Trauma and Chemical Poisoning,Daping Hospital,Army Medical University(Third Military Medical University),Chongqing,400042,China)

机构地区：[1]陆军军医大学(第三军医大学)大坪医院武器杀伤生物效应评估研究室,创伤与化学中毒全国重点实验室,重庆400042

出　　处：《陆军军医大学学报》2024年第12期1323-1335,共13页Journal of Army Medical University

摘　　要：目的采用密闭管道内气体爆炸方式,建立热辐射与冲击波复合致伤模型,探讨爆炸烧冲复合因素致大鼠重要器官伤情特点。方法8~10周龄雄性SD大鼠72只,体质量(200±10)g,随机分为对照组、轻度组、重度组。采用爆炸冲击波与热辐射致伤系统致大鼠不同程度损伤,并进行物理参数测试,伤后存活大鼠进行呼吸功能检测,24 h后解剖并检测血气、血液生化及血清炎症因子、肺损伤相关蛋白等指标,并观察肺组织及气管病理学形态变化情况。结果爆炸冲击波超压峰值范围为209~493 kPa,温度为152~258℃;轻度组死亡率为8.3%,重度组死亡率为53.1%;与对照组比较,伤后6 h内大鼠吸气时间(inspiratory time,Ti)、潮气量(Tidal Volume,TV)、松弛时间(relaxation time,Tr)增高(P<0.05),呼吸频率(respiratory rate,f)降低(P<0.05);伤后24 h二氧化碳分压(PaCO_(2))、碱剩余值(BE)、碳酸氢根(HCO_(3)^(-))值显著增高(P<0.05),氧分压(PaO_(2))显著降低(P<0.05);血清丙氨酸转氨酶(alanine transaminase,ALT)、天冬氨酸氨基转氨酶(aspartate aminotransferase,AST)、碱性磷酸酶(alkaline phosphatase,ALP)、总胆红素(total bilirubin,TBI)、总胆汁酸(total bile acid,TBA)水平均显著增高(P<0.05),白细胞介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、IL-6水平均显著增高(P<0.01);伤后大鼠气管黏膜层有不同程度的出血灶及发炎;肺损伤发生率高且病理表现为点片状出血至整肺叶弥漫性出血,肺泡间隔断裂,间隔增厚,红细胞及炎性细胞浸润,血清肺损伤相关蛋白水平显著增高(P<0.05)。结论建立出高度模拟密闭管道内轻至重度爆炸烧冲复合伤、能够满足研究需要的大鼠模型;爆炸烧冲复合伤以肺损伤、呼吸功能障碍、肝脏损伤及继发性感染为主。Objective To establish a model of combined injury of thermal radiation and blast wave of gas explosion in closed pipeline,and investigate the characteristics of important organ injury induced by burn-blast combined injury in rats.Methods A total of 72 male SD rats(aged 8~10 weeks,weighing 200~10 g)were randomly divided into control group and mild and severe injured groups.After the model rats were inflicted with blast wave and thermal radiation,their physical parameters were detected and measured.The respiratory function of the survival rats was tested.In 24 h later,arterial blood gas analysis,blood biochemical tests,and detection for serum inflammatory factors and lung injury related protein levels were performed,and the pathological changes in the lung tissue and trachea were observed.Results The peak range of explosive blast wave overpressure was 209~493 kPa,and the temperature was 152~258℃.The mortality rate was 8.3%in the mild group and 53.1%in the severe group.Compared with the control group,longer inspiratory time(Ti)and relaxation time(Tr)and larger tidal volume(TV)(P<0.05),while lower respiratory frequency(f)were observed in the 2 injured groups within 6 h after injury(P<0.05).At 24 h after injury,the values of partial pressure of carbon dioxide(PaCO_(2)),residual base value(BE)and bicarbonate(HCO_(3)^(-))were increased significantly(P<0.05),while partial pressure of oxygen(PaO_(2))was decreased(P<0.05).The serum levels of alanine transaminase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),total bilirubin(TBI)and total bile acid(TBA)were notably elevated(P<0.05).So were the levels of IL-1β,TNF-αand IL-6(P<0.01).Various severities of hyperemia foci and inflammation in the tracheal mucosa were observed in the injured rats.The incidence of lung injury was high,and the pathological manifestations were dot-shaped hemorrhage to diffuse hemorrhage of the whole lobe,rupture of alveolar septum,thickening of septum,and infiltration of red blood cells and inflammatory cells.The levels of serum l

关 键 词：爆炸 冲击波 烧冲复合伤 急性肺损伤 

分 类 号：R563[医药卫生—呼吸系统] R642[医药卫生—内科学] R644[医药卫生—临床医学]