犬颅脑枪伤后早期呼吸暂停时间对生存期的影响  

Effect of early apnea period on survival period in canines after craniocerebral gunshot wounds

作　　者：封亚平[1] 章翔[2] 李栋平[1] 武弋[2] 费舟[2] 封雨[1] 

机构地区：[1]解放军成都军区昆明总医院神经外科,云南省昆明市650032 [2]解放军第四军医大学西京医院全军神经外科研究所,陕西省西安市710032

出　　处：《中国临床康复》2004年第4期652-653,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:探讨颅脑枪弹伤后病理生理变化。方法:采用德国小口径步枪子弹随机致犬颅脑贯通伤(penetratingcran-iocerebralinjury,PCI)组及脑切线伤(tangentbraininjury,TBI)组模型。记录致伤前后呼吸、心率、心电图、平均动脉压、脑血流、脑电图等病理生理改变。结果:动物伤后均出现呼吸暂停,伤后动物平均呼吸暂停时间PCI组5.3min明显长于TBI组1.7min(P=0.0118),出现心率减慢、平均动脉压降低、动脉血流量减少等脑干抑制现象;颅内压逐渐升高;脑电活动消失,脑电图呈一直线;动物伤后平均存活时间,TBI组568min明显长于PCI组106min(P=0.0013)。结论:①伤后动物出现呼吸抑制、心率减慢和血压降低等短暂性抑制,积极有效的辅助呼吸能减少颅脑枪弹伤动物的死亡率。②颅内高压出现早且明显。③该模型伤后动物存活时间长,尤以TBI组更为理想。AIM:To study the pathophysiological changes in canines after craniocerebral g unshot wounds. METHODS:The canines were shot with small-bore musket made in Germany to est ablish animal models of penetrating craniocerebral injury(PCI) and tangent brain injury(TBI).The following measures were recorded,including respiratory frequenc y,heart rate(HR),electrocardiogram(ECG),mean arterial pressure(MAP),cerebral blo od flow,electroencephalogram(EEG) and so on. RESULTS:After injury,the mean time of apnea was 5.3 min in the PCI group,sign ificantly longer than in the TBI group(1.7 min)(P=0.011 8). Decrease occurred in HR,MAP,artery blood flow as a result of brainstem inhibition,while intracranial pressure had a tendency to increase gradually.A transient flat electroencephalo gram was seen immediately after the craniocerebral gunshot wounds.The average su rvival time of the canines in the TBI group was 568 min longer than that of the PCI group(106 min)(P=0.001 3). CONCLUSION:① Apnea,decreased HR and hypotension are effective in decreasing the mortality of canines caused by gunshot wounds.② Intracranial high pressure appeared early and obviously.③ The animal model,especially TBI model,survived f or a long time.

关 键 词：犬颅 脑枪伤 呼吸暂停时间 生存期 颅脑火器伤 心电图 脑血流 

分 类 号：R651.15[医药卫生—外科学] R-332[医药卫生—临床医学]