高原环境腹部爆炸伤后伤情与甲状腺激素水平变化的实验研究  

Study on changes of injury condition and thyroid hormone level after abdominal explosion injury in high altitude environment

作　　者：杨欣悦 李佳佳[1] 郭飞 屈金权 梁飞行 刘江伟[1] YANG Xinyue;LI Jiajia;GUO Fei;QU Jinquan;LIANG Feixing;LIU Jiangwei(Key Laboratory of High Altitude and Cold Medical Support at Xinjiang Military Region General Hospital,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆军区总医院高原高寒医学保障重点实验室,乌鲁木齐830000

出　　处：《医学研究与战创伤救治》2024年第10期1014-1020,共7页Journal of Medical Research & Combat Trauma Care

摘　　要：目的建立高原低压缺氧环境腹部爆炸伤动物模型,探讨高原低压缺氧环境对腹部爆炸伤后生命体征及甲状腺激素的影响及变化趋势并探讨相关机制。方法健康山羊24只,用随机数字表法分为2组(n=12):高原爆炸伤组(海拔约4700 m)和平原爆炸伤组(海拔约800 m)。将这2组实验羊放置在相应高度的场地进行爆炸致伤,观察并比较各组实验羊12 h生存情况、大体解剖情况,在相应时间点监测生命体征、记录生命体征,抽取静脉血,检测血清甲状腺激素水平。结果高原爆炸伤组腹水量高于平原爆炸伤组(P<0.05)。在2 h、8 h、10 h和12 h,高原爆炸伤组的收缩压高于平原爆炸伤组(P<0.05),在8 h、10 h和12 h,高原爆炸伤组的舒张压高于平原爆炸伤组(P<0.05)。在8 h、10 h和12 h,高原爆炸伤组心率高于平原爆炸伤组(P<0.05)。在8 h、10 h,高原爆炸伤组体温高于平原爆炸伤组(P<0.05)。在6 h、8 h、10 h和12 h,高原爆炸伤组T3水平高于平原爆炸伤组(P=0.000)。且各时间点(除2 h和6 h)HB组FT3水平高于PB组(P<0.05)。在8 h、10 h和12 h,高原爆炸伤组FT4水平高于平原爆炸伤组(P<0.05)。在6 h、8 h、10 h和12 h,高原爆炸伤组TSH水平低于平原爆炸伤组(P<0.05)。结论高原环境可明显加重腹部爆炸伤的损伤程度,可通过调节下丘脑-垂体-甲状腺(HPT)轴影响腹部爆炸伤后甲状腺激素的分泌,加速爆震伤后甲状腺激素动态变化的进程。Objective To establish an animal model of abdominal explosive injury in a hypobaric hypoxic environment at high-altitude,and explore the effects and trends of high-altitude environment on vital signs and thyroid hormones after abdominal explosive injury,and explore the relevant mechanisms.Methods 24 healthy goats were randomly divided into two groups(n=12):highaltitude explosive injury group(about 4700 m above sea level)and plain explosive injury group(about 800 m above sea level).The two groups of experimental goat were placed in the field at the corresponding heights for explosion induced injury.The survival and gross anatomy of experimental goat in each group were observed and compared for 12 h.Vital signs were monitored and recorded at the corresponding time points,venous blood was drawn,and serum thyroid hormone levels were detected.Results The amount of ascites in the high-altitude explosion injury group was higher than that in the plain explosion injury group(P<0.05).At 2 h,8 h,10 h,and 12 h,the systolic blood pressure of the high-altitude explosion injury group was higher than that of the plain explosion injury group(P<0.05).At 8 h,10 h,and 12 h,the diastolic blood pressure of the high-altitude explosion injury group was higher than that of the plain explosion injury group(P<0.05).At 8 h,10 h,and 12 h,the heart rate of the high-altitude explosion injury group was higher than that of the plain explosion injury group(P<0.05).At 8 h and 10h,the body temperature of the high-altitude explosion injury group was higher than that of the plain explosion injury group(P<0.05).At 6 h,8 h,10 h,and 12 h,the T3 level in the high-altitude explosion injury group was higher than that in the plain explosion injury group(P<0.05).At all time points(except for 2 h and 6 h),the FT3 level in the high-altitude explosion injury group was higher than that in the plain explosion injury group(P<0.05).At 8 h,10 h,and 12 h,the FT4 level in the high-altitude explosion injury group was higher than that in the plain explosion injury group

关 键 词：高原 低压缺氧 寒冷 腹部爆炸伤 甲状腺激素 

分 类 号：R641[医药卫生—外科学]