發(fā)布時間：2018-05-26 18:26

  本文選題：艙室內(nèi)爆炸 + 沖擊波煙霧復(fù)合傷　； 參考：《中國組織工程研究與臨床康復(fù)》2008年50期

【摘要】：背景:已證實沖擊波和煙霧均可引起機(jī)體顯著的血流動力學(xué)紊亂,但對沖擊波煙霧復(fù)合傷時血流動力學(xué)特點少有文獻(xiàn)報道。目的:探討艙室內(nèi)爆炸復(fù)合有害氣體對大鼠血流動力學(xué)早期變化的影響,評價腦鈉肽做為沖擊波煙霧復(fù)合傷早期檢測損傷指標(biāo)的可行性。設(shè)計、時間及地點:隨機(jī)分組,動物實驗觀察,于2006-08/2007-08在解放軍第三軍醫(yī)大學(xué)大坪醫(yī)院野戰(zhàn)外科研究所完成。材料:納入健康雄性SD大鼠104只,隨機(jī)分為3組:正常對照組8只,爆炸損傷組48只,復(fù)合損傷組48只。方法:將大鼠按模擬戰(zhàn)位固定于模擬艙室內(nèi),0.4g黑索金點紙質(zhì)爆源置于艙室中心爆炸,模擬沖擊波煙霧復(fù)合傷模型。復(fù)合損傷組大鼠在爆炸后放置100s取出,爆炸損傷組大鼠爆炸后立即取出,正常對照組不做處理。主要觀察指標(biāo):大鼠于傷后1,3,6,12,24,72h再次麻醉后行動脈插管觀察心功能變化,并采血,運(yùn)用雙抗體夾心法檢測血漿腦鈉素蛋白水平,取心臟病理標(biāo)本觀察心肺組織病理變化。結(jié)果:與正常對照組比較,爆炸損傷組和復(fù)合損傷組大鼠心肺病理形態(tài)學(xué),均有明顯改變,且復(fù)合損傷組比爆炸損傷組損傷嚴(yán)重。爆炸損傷組和復(fù)合損傷組大鼠血漿腦鈉肽在各時相點均高于正常對照組(P0.05),復(fù)合損傷組高于爆炸損傷組(P0.05)。左室內(nèi)壓最大下降速率、左室收縮壓、平均動脈壓與腦鈉肽質(zhì)量濃度的變化一致,而左室內(nèi)壓最大上升速率則呈負(fù)相關(guān)性。結(jié)論:腦鈉肽可做為沖擊波煙霧復(fù)合傷早期檢測損傷指標(biāo),艙內(nèi)爆炸煙霧復(fù)合傷對心肺損傷較單純爆炸損傷更加嚴(yán)重。
[Abstract]:Background: it has been proved that both shock wave and smoke can cause significant hemodynamic disturbance, but there are few literatures on hemodynamic characteristics of shock wave and smoke combined injury. Aim: to investigate the effect of explosion combined with harmful gases in cabin on the early changes of hemodynamics in rats, and to evaluate the feasibility of brain natriuretic peptide (BNP) as an early detection index of shock wave smoke combined injury. Design, time and place: randomized grouping, animal experimental observation, completed in 2006-08 / 2007-08 at the Institute of Field surgery, Daping Hospital, third military Medical University of the PLA. Materials: 104 male SD rats were randomly divided into three groups: normal control group (n = 8), explosive injury group (n = 48) and compound injury group (n = 48). Methods: the model of shock wave smoke compound injury was established by placing the papery explosion source of 0.4 g black rope gold point in the simulated compartment according to the simulated combat position. The rats in the compound injury group were taken out at 100 s after explosion, the rats in the explosion injury group were taken out immediately after explosion, and the normal control group was not treated. Main outcome measures: the changes of cardiac function were observed by arterial catheterization and blood collection after anaesthesia for 1 hour after injury. The plasma levels of brain natriuretic protein (BNP) were measured by double antibody sandwich method, and the pathological changes of heart and lung tissues were observed by taking heart and lung samples. Results: compared with the normal control group, the pathomorphology of heart and lung in the blast injury group and the compound injury group were obviously changed, and the injury in the compound injury group was more serious than that in the explosion injury group. The plasma brain natriuretic peptide (BNP) in the explosive injury group and the compound injury group was higher than that in the normal control group at all time points, and in the compound injury group was higher than that in the explosive injury group. The maximal rate of decrease of left ventricular pressure, left ventricular systolic pressure, and mean arterial pressure were consistent with the concentration of brain natriuretic peptide, but the maximum rate of increase of left ventricular pressure was negatively correlated with the concentration of brain natriuretic peptide. Conclusion: brain natriuretic peptide can be used as an early detection index of shock wave smoke combined injury. The damage of cardiopulmonary injury caused by explosion smoke combined injury in cabin is more serious than that of simple explosion injury.
【作者單位】： 解放軍第三軍醫(yī)大學(xué)大坪醫(yī)院神經(jīng)外科;
【基金】：全軍“十一五”醫(yī)學(xué)科研基金(06Z034)~~
【分類號】：R826

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本文編號：1938404