摘要
目的:探讨水下冲击伤的病理形态学改变。方法:成年杂种犬61只,山羊8只,用200,500和1000gTNT水下爆炸致水下冲击伤,PCB水下爆炸压力传感器测定冲击波物理参数,观察伤后6h动物的存活情况和冲击伤病理形态学改变。结果:水下冲击波物理参数的特征表现为高的峰值压力,正向持续时间较短,冲量较大。61只犬中,死亡23只,死亡率为37.7%(23/61),8只山羊中,死亡2只。形态学观察发现肺损伤发生率最高,其次为胃肠道损伤,少数动物可发生肝脾等实质脏器损伤,而膀胱和胆囊等含液脏器则很少发生损伤。肺损伤主要表现为不同程度的肺出血,重者常伴有肺水肿,甚至发生血性肺大泡和肺撕裂。胃肠道损伤主要表现为不同程度的浆膜下出血,部分动物可见浆膜下血肿和浆肌层撕裂,甚至发生胃肠道穿孔。肝脾等实质脏器可见包膜下出血、血肿,严重者发生肝脾破裂。形态学改变与冲击波物理参数明显有关,冲量越大,发生率越高,伤情也越重。结论:水下冲击伤具有伤情重和死亡率高的特点,早期救治中应加强急性呼吸窘迫、胃肠道穿孔和实质脏器引起的内出血的处理。
AIM:To investigate the pathomorphological changes of underwater blast injuries. METHODS:Sixty one adult mongrel dogs and 8 goats were exposed to the underwater explosion of 200,500 and 1 000 g TNT respectively.The physical parameters of blast wave were recorded by PCB pressure transducers specialized for underwater explosion.The survival amount and pathomorphological changes of animals were observed 6 hours after injury. RESULTS:The physical parameters of underwater blast wave were characterized by high peak pressure,short positive duration and great impulse.Twenty three among 61 dogs(37.7%) and 2 goats(2/8) died after the injury.Lung injuries ranked the highest percent of occurrence in morphological observation,and the second was gastrointestinal injuries.The injuries of liver,spleen and other parenchyma abdominal viscera were found in a small quantity of animals.Few injuries appeared in bladder and hollow abdominal organs.The predominant feature of the injured lung was the bleeding in different degrees.Edema,and even hemorrhagic bullae formation,ruptures were often seen in the severely injured lung.The injured gastrointestinal tract usually showed subserosa bleeding.Subserous hematoma,seromusclar layer rupture and perforation were found in some animals.The injured liver,spleen and other parenchyma organs mainly showed subcapsular bleeding and hemotoma.Rupture of liver and spleen appeared in some severely injured animals.There was a good relationship between the pathological changes and physical parameters.The greater the impulse was,the higher the incidence and the severer of injuries were. CONCLUSION:Underwater blast injuries are characterized by severe or critical injury and high mortality.More attention should be paid to the management of acute respiratory distress,gastrointestinal perforation and the inside hemorrhage caused by parenchyma organ injuries during the early treatment.
出处
《中国临床康复》
CSCD
2004年第5期895-897,T003,共4页
Chinese Journal of Clinical Rehabilitation
基金
军队"十五"指令性课题(01L067)~~
