高温高湿环境下犬肢体火器伤后伤道病理学改变  

PATHOLOGICAL STUDY ON GUNSHOT WOUND TRACK IN DOG UNDER HOT AND HUMID ENVIRONMENT

作　　者：赵东升[1] 裴国献[1] 魏宽海[1] 孙鸿涛[1] 罗炳德[2] 王前[3] 胡罢生[1] 

机构地区：[1]第一军医大学南方医院全军创伤骨科中心 [2]第一军医大学热带医学研究所高温医学研究室 [3]第一军医大学南方医院

出　　处：《解放军医学杂志》2003年第4期289-292,F004,共5页Medical Journal of Chinese People's Liberation Army

基　　金：全军"九五"医药卫生杰出中青年基金 (编号 98J0 0 4 );全军医学科研"十五"计划重点课题 (编号 0 2Z0 0 1 )资助课题

摘　　要：为研究高温高湿环境下犬肢体火器伤后伤道的病理学改变 ,将 8只犬随机分为高温高湿 (HHE)组和常温常湿 (NE)组 ,分别于火器伤后 4、8、12、2 4h进行大体和病理形态学观察 ,测定挫伤区、震荡区和震荡外区的ATP、ADP、AMP及能荷含量。结果发现 ,HHE组大体病理改变较NE组明显加重 ;光镜及电镜观察到HHE组各区肌肉纤维的病理变化均较NE组显著 ,且呈进行性加重 ,而NE组的震荡区及震荡外区 2 4h伤道组织病理变化均有减轻趋势。ATP在HHE组伤后 8、12、2 4h挫伤区及伤后 2 4h震荡区较NE组低。ADP在HHE组伤后 8h挫伤区及伤后 12、2 4h震荡区较NE组低。AMP在HHE组挫伤区 12h后明显高于NE组。HHE组伤后 8h震荡区及伤后 12、2 4h挫伤区能荷较NE组降低。说明高温高湿环境下肢体火器伤伤道肌肉组织病理损伤严重 ,且随时间的延长而逐渐加重 ;肌组织能量储备匮乏 ,且随时间延长能量储备显著下降 ;其处理更应强调及早、彻底的清创。To investigate the pathological changes in gunshot wound track in limbs of dogs produced under a hot and humid environment, 8 dogs were randomly divided into two groups: hot and humid environment group (HHE) and normal environment group(NE). Gross examination, optical microscopic examination (OM), electron microscopic examination (EM) were performed, and ATP, ADP, AMP content, energy charge (EC) in the gunshot wounds were observed at 4, 8, 12, 24h after wounding. The results indicated that 6～8 h after the injury, the wound tracks and discolored area of tissue in HHE group were more distinguished and enlarged than those in NE group, and the swelling of wounded limbs was obvious. Some of the wounds began to be odoriferous. The signs of infection began to be obvious. While the wounds of NE group did not give off obvious odor of decay until 12～24h after the injury. Under OM and EM, necrosis and damage of muscle fibers in the wound tracts were more obvious in the HHE group than that in NE group, showing a tendency of deterioration. In contrast the changes in the injured tissues in NE group showed a tendency of improving. ATP content of the injured tissues in the contusion region of HHE group was lower than that of NE group at 8h, ATP content of tissues in the shock region of HHE group was decreased continuously and was lower than that of NE group at 12h. ADP content of tissues in the contusion area of HHE group was lower than that of NE group at 8h and also in shock area at 12h. AMP content of tissues in the contusion area of HHE group was higher than that of NE group at 12h, whereas EC of tissues in the contusion area of HHE group was lower than that of NE group at 8h and 12h. Histopathological changes in tissues in the gunshot wound were serious and deteriorated gradually in hot and humid environment. At the same time the energy storage of muscle tissue in the gunshot wound track was lower and decreased more remarkably in this environment. Therefore early and complete debridement of gunshot wounds inflicted in h

关 键 词：高温高湿环境 犬 肢体火器伤 伤道病理学改变 

分 类 号：R826.5[医药卫生—临床医学]