摘要
目的:研究低温条件下火器性骨折的损伤特点,探讨早期恢复骨连续性的方式方法,为寒区火器性骨折的治疗提供参考。方法:采用东北地区杂种犬24只,标准驯养二周后,随机分成伤后8小时、24小时内固定和外固定组(n=6),致伤前动物及弹丸同时置-40℃条件下1小时,3%戊巴比妥纳静脉麻醉,迅速移到室外靶道(—20℃),射距20米,犬单后肢股骨中段致伤。伤后8小时、24小时无菌操作下取伤道组织、抽血、并进行清创,观察局部损伤效应,分别进行钢板螺丝钉内固定和外固定手术。术后自由摄食喂养,并进行局部情况、引流量、体温、血常规及血培养等观察。结果:低温条件下火器性骨折局部损伤效应较常温条件下重,伤后8小时,伤道组织菌量增加缓慢,仅达10~4cfu/g,伤后24小时达10~6cfu/g,内固定组与外固定组炎症反应、骨愈合时间无明显差异(P>0.05)。结论:提示低温对火器伤后伤道组织的菌量变化有明显影响,组织厚度小于10cm,彻底清创、良好引流前提下早期骨折内固定具有一定可行性。
Objective: To investigate the injury characteristics of firearm bone fracture under low-temperature conditions, and to provide experimental basis for the treatment of firearm bone fracture in frigid zone. Methods: After a two-week training, 24 mongrels were randomly divided into internal fixation and external fixation groups 8 and 24 hours respectively after injury(n= 6 in each subgroup). Before injury, animals and bullets were subjected to -40℃ for an hour simultaneously. Animals were anesthetized and moved to outdoor condition(-20℃). The shooting distance was 20meters, and the middle third of one femur was shot by a rifle. Biopsies were taken from the wound track, blood specimen taken and debridement was done under aseptic condition at 8 and 24 hours after the injury, respectively. Then the femurs were either internally or externally fixed using steel plates and screw or external fixation device. After the operation, animals were observed and fed freely. The local appearance, drainage volume, body temperature, routine blood test and culture of blood were made in all animals. Result:The injuring effects on the local wounds induced by firearm under low-temperature were more serious than that in wounds induced under usual temperature. The bacterial count of wounded tissue increased slowly up to 10~4cfu/g at 8 hours after wounding, and 10~6cfu/g at 24 hours. Inflammatory response and bone healing time in internally fixed group were not obviously different from that of externally fixation group (P>0.05). Conclusion: The low temperature has obvious effect on the change in bacterial count in wounded tissue after compound fracture due to firearm. If the soft tissue thickness is less than 10cm, early intenal fixation might be performed under the condition of good drainage and wound debridement.
出处
《感染．炎症．修复》
2000年第2期103-105,共3页
Infection Inflammation Repair
关键词
火器伤
骨折
内固定
感染
Firearm wound Bone-tracture Internal toxation Intection
