發(fā)布時(shí)間：2018-04-20 08:49

  本文選題：眼創(chuàng)傷 + 作戰(zhàn)密閉艙　； 參考：《第三軍醫(yī)大學(xué)》2003年碩士論文

【摘要】： 實(shí)驗(yàn)?zāi)康?本研究在兩個(gè)特殊環(huán)境—以坦克為代表的“密閉艙室”和海拔3658米的高原，利用實(shí)彈爆破和實(shí)彈射擊現(xiàn)場試驗(yàn)，分別對密閉艙室內(nèi)乘員(綿羊)和急進(jìn)高原豬致傷，觀察作戰(zhàn)兵器密閉艙室內(nèi)乘員(綿羊)高爆武器傷后，艙室內(nèi)有害氣體、溫度、沖擊波和全身及眼部傷情；急進(jìn)高原豬后肢高速槍彈傷后的間接眼損傷傷情和傷前、傷后動(dòng)脈血中PH、PCO2、BE、O2SAT%、PO2的變化。探討在不同類型武器致傷后，特殊環(huán)境(密閉艙室、高原)對動(dòng)物眼創(chuàng)傷的影響；以及眼部傷情特點(diǎn)與不同武器致傷效應(yīng)之間的關(guān)系。為具有密閉艙室空間結(jié)構(gòu)及急進(jìn)高原環(huán)境人員眼創(chuàng)傷的防治提供實(shí)驗(yàn)依據(jù)。 本研究分兩個(gè)部份： 實(shí)驗(yàn)一：作戰(zhàn)兵器密閉艙室內(nèi)乘員眼創(chuàng)傷的實(shí)驗(yàn)研究 實(shí)驗(yàn)二：急進(jìn)高原豬后肢高速槍彈傷后間接眼損傷的實(shí)驗(yàn)研究 實(shí)驗(yàn)方法 實(shí)驗(yàn)一：將60只健康綿羊隨機(jī)分成4組分批布放于坦克艙內(nèi)，分別用105mm破甲彈(I組)、海雙37mm穿甲爆破燃燒彈(II組)、12.7mm穿甲燃燒彈(III組)三種不同類型的反坦克武器射擊坦克前甲板，用反坦克地雷(Ⅳ組)靜爆坦克，測定武器爆炸后的沖擊波超壓和持續(xù)時(shí)間，及前三種武器爆炸前后坦克內(nèi)的溫度變化和爆炸后坦克內(nèi)有害氣體的含量。致傷后，立即行眼部大體情況觀察，并于傷后24小時(shí)內(nèi)活殺動(dòng)物，同時(shí)行全身大體解剖觀察，摘取眼球行光鏡、電鏡觀察。 實(shí)驗(yàn)二：將30頭平原豬于2小時(shí)內(nèi)送入海拔3658米的高原，進(jìn)入高原后72小時(shí)，分批用五三四滑膛槍發(fā)射1.03g鋼珠彈致傷28頭豬右后肢，同時(shí)測定彈速。于傷前1小時(shí)，傷后1、6、24小時(shí)測血?dú)�，傷�?4小時(shí)宰殺，并對全身各器官及眼進(jìn)行大體觀察，取眼球行光鏡、電鏡觀察。 實(shí)驗(yàn)結(jié)果 實(shí)驗(yàn)一： 1. 各彈種爆炸后的溫度、有害氣體、沖擊波超壓及持續(xù)時(shí)間、全身傷情： (1) I組：平均升溫7.01℃，武器爆炸后最高溫度與爆炸前溫度相比差異非常顯著(P0.01)。氮氧化物、SO2、CO值分別為20ppm、15ppm、465ppm；平均沖擊波超壓和持續(xù)時(shí)間分別為：62.3kPa、3.9ms。16只羊受傷率100%,受傷部位以胸腹部最多，6只羊在肺部沒有破片傷的情況下出現(xiàn)了肋骨壓痕、肺及心內(nèi)膜點(diǎn)片狀出血。 WP=9 (2) II組：平均升溫4.62℃，武器爆炸后最高溫度與爆炸前溫度相比差異顯著(P0.05)。氮氧化物、SO2、CO分別為5.5ppm、4ppm、65ppm。平均沖擊波超壓和持續(xù)時(shí)間分別為：31.5kPa、3.4ms，與I組相比差異顯著(P0.05)。16只羊受傷率100%,受傷部位以胸腹部最多，3只羊出現(xiàn)了肺和心內(nèi)膜的點(diǎn)片狀出血。 (3) III組：平均升溫1.85℃。氮氧化物、SO2、CO值分別為2ppm、0.15ppm、2ppm。平均沖擊波超壓和持續(xù)時(shí)間分別為：3.6kPa、4ms，與I組相比差異非常顯著(P0.01)。16只羊中8只受傷,受傷率50%,受傷部位以胸腹部最多。另外8只羊大體未見明顯傷情。 (4) IV組：平均沖擊波超壓和持續(xù)時(shí)間分別為：18.1kPa、0.4ms，與I組相比差異非常顯著(P0.01)。12只羊中10只受傷，受傷率83.3%。受傷部位以顱腦傷為主，且均為閉合性損傷。另外2只羊大體未見明顯傷情。 2. 各彈種所致眼部傷情及眼組織病理學(xué)觀察： (1) 眼部大體傷情： 所有眼球均可見結(jié)膜充血。I組和II組除發(fā)生了眼球破裂、眼內(nèi)容物脫出、角膜鞏膜緣穿通傷和球內(nèi)出血外，I組還發(fā)生了眶骨骨折；II組還發(fā)生了眼內(nèi)異物。 (2) 組織病理學(xué)觀察： 光鏡：各組均可見角膜上皮水腫；葡萄膜和視網(wǎng)膜血管顯著擴(kuò)張、血細(xì)胞淤積；球內(nèi)出血；部份視網(wǎng)膜神經(jīng)纖維層水腫、RGCs及內(nèi)核層空泡樣變、視細(xì)胞外節(jié)斷裂、結(jié)構(gòu)紊亂。除上述改變外，經(jīng)I組還出現(xiàn)有局限性滲出性視網(wǎng)膜脫離、視網(wǎng)膜壞死及斷裂；II組還出現(xiàn)有局限性滲出性視網(wǎng)膜脫離；IV組瞳孔緣處的晶狀體前囊膜上有類似Vossius環(huán)的色素沉著。 電鏡：內(nèi)界膜斷裂；神經(jīng)纖維層軸漿腫脹；視細(xì)胞線粒體腫脹；RGCs胞質(zhì)空化，髓樣結(jié)構(gòu)形成，出現(xiàn)核溶解。 實(shí)驗(yàn)二： 1. 致傷物物理參數(shù)：測得五三四滑膛槍(射距10米)發(fā)射1.03g鋼珠彈的彈速為935.06±27.4米/秒。 2. 血?dú)庵笜?biāo)： (1) 傷前1小時(shí)：PCO2、O2SAT%、PO2明顯低于正常值。 (2) 傷后1小時(shí)：PH升高超過正常值，PCO2、O2SAT%、PO2值較傷前更低。與傷前1小時(shí)比較，傷后1小時(shí)的PH、PCO2、BE、PO2差異顯著(P0.05)。 (3) 傷后6小時(shí)：PH繼續(xù)升高，PCO2、O2SAT%、PO2值進(jìn)一步降低。與傷前1小時(shí)比較，傷后6小時(shí)的PH、PCO2、BE、PO2差異非常顯著(P0.01)。 (4) 傷后24小時(shí)：PH恢復(fù)正常，PCO2、O2SAT%、PO2有所回升，但仍低于正常 WP=10 值，BE負(fù)值增大，超過正常值。與傷前1小時(shí)比較，傷后24小時(shí)的PCO2、BE值差異非常顯著(P0.01)。 傷前、傷后各時(shí)相呈低氧血癥，呼吸性堿中毒。傷后24小時(shí)，合并代謝性酸中毒。 3. 全身及眼部大體情況：除原發(fā)傷道外，有5頭豬的肺部可見點(diǎn)片狀出血。眼部大體未見明顯異常。 4. 眼組織病理學(xué)觀察： 光鏡：前房滲出；睫狀突水腫，血管擴(kuò)張、血細(xì)胞淤積；脈絡(luò)膜和視網(wǎng)膜血管擴(kuò)張、血細(xì)胞淤積；局限性滲出性視網(wǎng)膜脫離；不同程度的后RGCs和內(nèi)核層空泡樣變，神經(jīng)纖維層水腫，視細(xì)胞外節(jié)斷裂、結(jié)構(gòu)不清。 電鏡：視細(xì)胞部分膜盤擴(kuò)大呈囊泡狀，膜盤結(jié)構(gòu)破壞；雙極細(xì)胞線粒體普遍腫
[Abstract]:The purpose of the experiment
In this study, two special environments, the "closed cabin" represented by tanks and the altitude of 3658 meters above sea level, were used in the field test of real bomb blasting and real missile shooting to observe the injury to the indoor occupants (sheep) and the high altitude pigs in the airtight cabin, and to observe the harmful gas and temperature in the cabin after the high explosive weapon injury in the airtight cabin of the combat weapon. Degree, shock wave and whole body and eye injury; the changes of PH, PCO2, BE, O2SAT%, PO2 in the arterial blood of high altitude pigs after rapid gunshot wound on the hind limbs of plateau pigs. The influence of special environment (closed cabin, plateau) on the ocular trauma after the injury of different types of weapons; and the characteristics of eye injuries and different weapons. The relationship between the wound effects and the experimental results is provided for the prevention and treatment of ocular trauma in closed cabin space structure and rapid altitude environment.
This study is divided into two parts:
Experiment 1: Experimental Study on eye injuries of occupants in closed arms of operational weapons
Experiment two: Experimental Study on indirect eye damage after gunshot wound in pig hind limb speed at high altitude
Experiment method
Experiment 1: 60 healthy sheep were randomly divided into 4 groups in batches and placed in tank cabin, respectively, using 105mm shell bomb (group I), sea double 37mm piercing fire bomb (group II), 12.7mm armor piercing projectile (group III) with three different types of antitank weapons shooting the front deck of tank, and using antitank mine (Group IV) statically detonating tank to measure the impact after the weapon explosion. The temperature changes in the tank before and after the first three weapons exploded and the content of the harmful gas in the tank after the explosion. After the injury, the eye was observed immediately after the injury, and the animals were killed within 24 hours after the injury. At the same time, the general anatomy of the whole body was observed and the eyeball was taken and observed by the electron microscope.
Experiment two: 30 plain pigs were sent to the plateau of 3658 meters in 2 hours and 72 hours after entering the plateau. 28 pig right hind limbs were wounded by 1.03g steel ball fired with 534 pistol guns in batches. At the same time, the bullet speed was measured at the same time. The blood gas was measured at the time of 1 hours before injury, the blood gas was measured at 1,6,24 hours after injury, and the injury was slaughtered for 24 hours after the injury, and the organs and eyes of the whole body were observed in general. The eyeball was taken with the light microscope and the electron microscope was observed.
experimental result
Experiment 1:
1. the temperature, harmful gas, shock wave overpressure and duration of each bomb after the explosion.
(1) I group: the average temperature was 7.01 C, the maximum temperature after the weapon explosion was significantly different from that before the explosion (P0.01). The nitrogen oxides, SO2, and CO values were 20ppm, 15ppm, 465ppm respectively. The average shock wave overpressure and duration were 62.3kPa, the 3.9ms.16 sheep were injured 100%, the injured parts were most in the chest and abdomen, and 6 sheep were not in the lungs. In the case of fragment injury, ribs appeared, and pulmonary and endocardial spots were bleeding.
WP=9
(2) II group: the average temperature was 4.62 degrees centigrade, and the maximum temperature after the weapon explosion was significantly different from that before the explosion (P0.05). Nitrogen oxides, SO2, CO were 5.5ppm, 4ppm, 65ppm., respectively: 31.5kPa, 3.4ms, respectively, 31.5kPa, 3.4ms, compared with I group (P0.05).16 only sheep injury rate 100%, the injured site was the most thoracic abdomen, 3 The sheep had a spotty bleeding from the lungs and the endocardium.
(3) III group: the average temperature increased 1.85 degrees. Nitrogen oxides, SO2, CO values were 2ppm, 0.15ppm, 2ppm., respectively: 3.6kPa, 4ms, respectively, 3.6kPa, 4ms, the difference was very significant compared with the I group (P0.01).16, only 8 sheep were injured, the injury rate was 50%, the injured part was most in the chest and abdomen. The other 8 sheep had not been significantly injured.
(4) IV group: the average shock wave overpressure and duration were 18.1kPa, 0.4ms respectively. Compared with the I group, the difference was very significant (P0.01) in 10 sheep in the sheep, and the injury rate of the injured part of the 83.3%. was mainly with craniocerebral injury. The other 2 sheep had no obvious injury in the other 2 sheep.
2. ocular injury and ocular histopathological observation of each species.
(1) gross injury in the eye:
All eyeballs showed conjunctival congestion in group.I and group II, except for eyeball rupture, eye volume removal, corneal scleral perforation and intravitre hemorrhage, I group also had orbital bone fracture, and intraocular foreign body occurred in group II.
(2) histopathological observation:
Light microscopy: corneal epithelial edema was seen in all groups; significant dilatation of the vineal and retinal vessels, hematocyte deposition, hemorrhage in the bulb, edema of the nerve fiber layer in the retina, RGCs and the vacuolation of the core layer, the rupture of the outer segment of the cell and the disorder of the structure. In addition to the above changes, there were localized exudative retinal detachment, and the retina through the I group. Membrane necrosis and rupture; group II also had localized exudative retinal detachment; in group IV, there was a Vossius ring like pigmentation on the anterior capsule of the pupil edge.
Electron microscopy: internal limiting membrane ruptured; axonal swelling of nerve fiber layer; mitochondria swelling of optic cells; RGCs cytoplasm cavitation, medullary structure formation, nuclear dissolution.
Experiment two:
1. vulnerant parameters: measured 534 muskets (range 10 meters) to launch the 1.03g steel ball projectile velocity is 935.06 + 27.4 M / sec.
2. blood gas indicators:
(1) 1 hours before injury: PCO2, O2SAT% and PO2 were significantly lower than normal.
(2) 1 hours after injury: PH higher than normal value, PCO2, O2SAT%, PO2 value lower than before injury. Compared with 1 hours before injury, 1 hours after injury, PH, PCO2, BE, PO2 significant difference (P0.05).
(3) 6 hours after injury: PH continued to rise, while PCO2, O2SAT% and PO2 decreased further. Compared with 1 hours before injury, the difference of PH, PCO2, BE and PO2 at 6 hours after injury was very significant (P0.01).
(4) 24 hours after injury: PH returned to normal, while PCO2, O2SAT% and PO2 recovered, but were still below normal.
WP=10
The negative value of BE increased and exceeded the normal value. Compared with the 1 hours before injury, the difference of PCO2 and BE value at 24 hours after injury was very significant (P0.01).
Hypoxemia and respiratory alkalosis were found at various times after injury, and 24 hours after injury, combined with metabolic acidosis.
3. the general condition of the whole body and the eyes: except for the primary wounds, there were spotty hemorrhage in the lungs of 5 pigs.
The histopathological observation of 4. eyes:
Light microscopy: anterior chamber exudation; ciliary process edema, vasodilatation, blood cell deposition; choroidal and retinal vascular dilatation, blood cell deposition; localized exudative retinal detachment; different degrees of posterior RGCs and core vacuoles, nerve fiber layer edema, optic cell segment fracture, and unclear structure.
Electron microscopy: some cells of the optic cells expanded into vesicles, and the membrane plates were destroyed. Mitochondria of bipolar cells were generally swollen.

【學(xué)位授予單位】：第三軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2003
【分類號】：R82

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