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目的探讨濒海实地环境下建立稳定、可重复的海水浸泡状态下兔肠管枪弹伤动物模型。方法濒海实地环境下,30只新西兰兔随机分为海水浸泡状态下预热型实验用气步枪(专利号:ZL201420403237.X)致肠管枪弹伤组(气步枪组,n=15)、海水浸泡状态下54式手枪致肠管枪弹伤组(手枪组,n=15)。将兔麻醉后以45°仰卧位固定于自制支架,浸泡于海水后,在距离0.5 m处分别用预热型实验用气步枪、54式手枪射击左麦氏点,然后在30、60、120、240 min,分别比较两组动物外周血白细胞计数及C-反应蛋白(CRP)水平的变化;在海水中观察30 min后,行剖腹探查术,统计两组动物24 h后存活率。结果除第30 min外,在60、120、240 min各时间点,两组外周血白细胞计数及CRP水平比较差异均无统计学意义(P均>0.05)。气步枪组可见肠系膜血管损伤1只;手枪组可见肝脏损伤1只、脾脏损伤3只、肠系膜血管损伤6只,且肠系膜血管损伤较气步枪组严重。病理检查结果显示,气步枪组动物肠管破裂处炎症细胞浸润严重。伤后24 h气步枪组死亡4只,手枪组死亡10只,气步枪组伤后24 h存活率明显高于手枪组(73.3%vs 33.3%,P<0.05)。结论预热型实验用气步枪致海水浸泡状态下新西兰兔肠管枪弹伤动物模型稳定、可重复,可为海水中肠管枪弹伤的术式研究及早期救治提供研究基础。
Objective To explore a stable and repeatable animal model of intestine-gunshot wound under sea-immersed condition in coastal littoral environment. Methods Thirty New Zealand white rabbits were randomly divided into three groups: control group (n = 15) with intestine gunshot wound, preheated experimental air rifle with seawater immersion (patent No .: ZL201420403237.X) State Type 54 pistol caused by intestinal gun bullet wound group (pistol group, n = 15). The rabbits were anesthetized and fixed in self-made scaffolds at 45 ° supine position. After soaking in seawater, the rabbits were left to shoot at the pre-heated experimental air rifle and the 54-type pistol at a distance of 0.5 m, , 240 min respectively. The changes of peripheral blood leukocyte count and C-reactive protein (CRP) were compared between the two groups. After 30 minutes of observation in seawater, the laparotomy was performed and the survival rate of the two groups was calculated. Results There were no significant differences in peripheral blood leukocyte counts and CRP levels between the two groups except for the 30th minute at 60, 120 and 240 minutes (all P> 0.05). 1 gastrocnemius vascular injury was seen in the air rifle group; 1 liver injury, 3 spleen injury and 6 mesenteric vascular injury were seen in the pistol group, and the damage of the mesenteric blood vessel was more severe than that of the air rifle group. Pathological examination showed that infiltration of inflammatory cells in the rupture of the intestine in the air rifle group was severe. Four deaths occurred in the air rifle group and 10 deaths in the pistol group after 24 h of injury. The survival rate of the air rifle group at 24 h after injury was significantly higher than that of the pistol group (73.3% vs 33.3%, P <0.05). Conclusion The animal model of New Zealand white rabbit intestine-gunshot wound caused by pre-heated experimental air rifle was stable and repeatable, which could provide the research basis for surgical reseach and early rescue of intestinal gun wound in seawater.