开放爆炸环境下烧冲复合伤动物模型建立的研究

发布时间：2018-05-06 08:27

本文选题：烧冲复合伤 + 模型　；参考：《中华损伤与修复杂志(电子版)》2014年06期

【摘要】：目的建立理想的开放爆炸环境下烧冲复合伤动物模型。方法以Wistar雌性清洁级成年大鼠460只为研究对象。随机选取90只大鼠设为预实验组,其余370只大鼠随机选取360只大鼠设为实验组,剩余10只大鼠设为正常对照组。预实验组90只大鼠随机分为预单纯烧伤组(n=30),预烧冲复合伤组(n=30),预烧冲复合伤组(n=30);预单纯烧伤组采用凝固汽油涂抹背部点燃25 s造成深Ⅱ度烧伤,烧伤面积分别为10%总体表面积(TBSA)(轻度,n=10)、25%TBSA(中度,n=10)、40%TBSA(重度,n=10);预单纯冲击伤组采用柱形黑索金炸药在不同距离(70、50、30 cm)造成轻度、中度、重度冲击伤(每组n=10);按照预单纯烧伤组及预单纯冲击伤组动物死亡率及器官功能障碍等,确定轻度、中度、重度的预烧冲复合伤模型:预轻度烧冲复合伤(轻度烧伤+轻度冲击伤),预中度烧冲复合伤(中度烧伤+中度冲击伤),预重度烧冲复合伤(重度烧伤+重度冲击伤);观察伤后24 h大鼠宏观变化及死亡率。实验组370只大鼠随机分为单纯烧伤组(n=120,其中轻、中、重3组,每组n=40),单纯冲击伤组(n=120,其中轻、中、重3组,每组n=40),烧冲复合伤组(n=120,其中轻、中、重3组,每组n=40),正常对照组(n=10),模型的建立同预实验,伤后6 h、1 d、2 d、3 d用自动生化仪检测实验组大鼠血清肌酸激酶同工酶(CK-MB)、谷丙转氨酶(GPT)、血肌酐(Scr),并同时观察实验组大鼠死亡率及用光学显微镜观察各脏器病理变化。结果预轻、中、重度冲击伤组大鼠伤后24 h死亡率分别为10%、30%、100%;预轻、中、重度烧伤组大鼠伤后24 h死亡率分别为10%、20%、40%;预轻、中、重度烧冲复合伤组大鼠伤后24 h死亡率分别为20%、30%、100%;预冲击伤组:预重度冲击伤组大鼠均可见骨膜穿孔,均有球结膜出血,9例可见口腔黏膜破溃出血。预中度冲击伤组大鼠仅1例出现可见骨膜穿孔,9例出现球结膜出血,5例可见口腔黏膜破溃出血。预轻度冲击伤组大鼠未见骨膜穿孔及球结膜出血,未见口腔黏膜破溃出血。预单纯烧伤组:创面渗出较少,未见明显分泌物形成。预烧冲复合伤组:各器官表现基本同预单纯冲击伤组,创面变化基本同预单纯烧伤组。实验组大鼠伤后6 h、1 d、2 d、3 d的死亡率:单纯冲击伤组:轻度冲击伤组各时相点的死亡率分别为2.5%、10%、10%、10%,中度冲击伤组各时相点的死亡率分别为5%、20%、30%、40%,重度冲击伤组各时相点的死亡率分别为15%、50%、65%、75%,单纯烧伤组:轻度烧伤组各时相点的死亡率分别为5%、10%、20%、20%,中度烧伤组各时相点的死亡率分别为5%、20%、30%、30%,重度烧伤组各时相点的死亡率分别为10%、40%、65%、75%;烧冲复合伤组:轻度烧冲复合伤组各时相点的死亡率分别为7.5%、20%、20%、20%,中度烧冲复合伤组各时相点的死亡率分别为10%、30%、40%、40%,重度烧冲复合伤组大鼠伤后6、24 h的死亡率分别为25%、100%。轻度烧冲复合伤组CK-MB在伤后1 d增加明显,伤后2 d迅速下降,伤后3 d接近正常水平。GPT、Scr未见明显变化。中度烧冲复合伤组伤后6 h至伤后3 d均伴有不同程度器官功能障碍,CK-MB、GPT、Scr测定出现持续性异常增高。心脏:CK-MB在伤后6 h即开始增加,伤后1 d增加明显,至伤后2 d逐步下降,伤后3 d仍高于正常水平;肝:GPT在伤后6 h即开始异常,伤后1 d进一步增加,至伤后2 d达峰值,伤后3 d仍高于正常水平;肾:Scr在伤后6 h变化不明显,伤后1 d略有增加,至伤后2 d增加明显,伤后3 d略有下降仍高于正常水平,伤后2 d中度烧冲复合伤组大鼠CK-MB(241.42±33.31)HU/L、GPT(127.71±11.54)U/L、Scr(95.37±13.02)μmol/L与正常对照组(84.12±12.64)HU/L、(42.28±10.44)U/L、(53.53±12.71)μmol/L比较,差异有统计学意义(t=3.327、4.081、2.508,P0.05);重度烧冲复合伤组CKMB、GPT、Scr均在伤后6 h即开始异常明显增加。心、肝、肾、肺脏、小肠均有不同程度出血、充血、炎症反应等病理学改变。结论根据实验组动物死亡率,以及存活动物脏器功能及病理形态学变化情况进行判断,中度烧冲复合伤组是较理想的烧冲复合伤动物模型。
[Abstract]:Objective to establish an ideal burning and burst compound injury animal model in the open explosion environment. Methods 460 adult rats of Wistar clean grade rats were studied. 90 rats were randomly selected as pre experimental group. The remaining 370 rats were randomly selected as experimental group, and the remaining 10 rats were set as normal control group. 90 rats in the pre experiment group were randomly selected as the normal control group. The machine was divided into pre pure burn group (n=30), pre burn combined injury group (n=30) and pre burn combined injury group (n=30). The pre pure burn group used Napa to burn 25 s on the back to cause deep second degree burn. The area of burn area was 10% total surface area (TBSA) (mild, n=10), 25%TBSA (moderate, n=10), 40%TBSA (severe, n=10); pre pure impact injury group was used. A mild, moderate, severe impact injury (each group of n=10) was produced at different distance (70,50,30 cm), and a mild, moderate and severe pre burn combined injury model was established according to the mortality and organ dysfunction of the pre pure burn group and the pre simple shock injury group, and the pre mild burn combined injury (mild burn + mild shock injury) was pretreated. Moderate burn combined injury (moderate burn + moderate impact injury), pre severe burn combined injury (severe burn + severe impact injury), and observed the macro changes and mortality of 24 h rats after injury. 370 rats in the experimental group were randomly divided into simple burn group (n=120, light, medium, 3 groups, n=40), and simple impact group (n=120, light, medium, weight, 3 groups, n=4 0) the burning and flushing compound injury group (n=120, light, medium, heavy 3 groups, each group n=40), the normal control group (n=10), the model was established with the pre experiment, after 6 h, 1 D, 2 D, 3 D detected the serum creatine kinase isoenzyme (CK-MB), Gu Bingzhuan ammonia enzyme (GPT), and blood creatinine (Scr) in the experimental group, and observed the mortality of the experimental group and the use of optical display. Results the mortality of 24 h after injury in the pre light, moderate and severe group was 10%, 30%, 100%, and the mortality rate of 24 h after injury in the pre light, moderate and severe burn group was 10%, 20%, 40%, and the mortality rate of 24 h in the pre light, moderate, severe and severe burn combined injury group was 20%, 30%, 100%, pre severe injury group: pre severe Percussion Group: pre severe impact group: pre severe impact group: pre severe impact group: pre severe shoot group: pre severe shoot group: pre severe shoot group: pre severe shoot group: pre severe shoot group: pre severe shoot group: pre severe Percussion Group: pre severe injury group All the rats in the injured group showed periosteum perforation with bulball conjunctiva bleeding and 9 cases of oral mucosa rupture and bleeding. Only 1 cases of pre moderate impact injury group showed periosteum perforation, 9 cases of bulbar conjunctiva bleeding and 5 cases of oral mucosa rupture and bleeding. No periosteum perforation and bulbar conjunctiva bleeding were found in the pre mild shock injury group, no oral mucosa rupture was found. Bleeding. Pre pure burn group: the wound exudation was less and no obvious secretion was found. Pre burn combined injury group: all organs were basically the same pre simple shock injury group, the wound change was basically the same as presimple burn group. The death rate of 6 h, 1 D, 2 D, 3 D after injury in the experimental group: simple impact injury group: the mortality of each phase point in mild shock injury group The mortality rate of each phase point in the group of 2.5%, 10%, 10%, 10% were 5%, 20%, 30%, 40%, and the mortality rate of each phase point in the severe shock group was 15%, 50%, 65%, 75%, and simple burn group: the mortality rate of each phase point in the mild burn group were 5%, 10%, respectively. The mortality rate of each time point in the severe burn group was 10%, 40%, 65%, 75%, and the mortality rate of each time point in the mild burn combined injury group was 7.5%, 20%, 20%, 20%, and the mortality of each phase point of the group was 10%, 30%, 40%, 40%, and the mortality of 6,24 h in the severe burn combined injury group was 25%, 10 respectively. The increase of CK-MB in 0%. mild burn combined injury group was obviously increased at 1 d after injury, and 2 D decreased rapidly after injury. 3 d after injury was close to normal level.GPT, and there was no obvious change in Scr. 6 h to 3 d after injury in moderate burn combined injury group was accompanied by different degrees of organ dysfunction, CK-MB, GPT, and Scr determination appeared persistent abnormal increase. 6 Increase, 1 d after injury increased significantly, to 2 d after injury gradually decreased, 3 d after injury still higher than the normal level, liver: GPT after 6 h after injury, after injury, further increase, to 2 d after injury to the peak, 3 d after injury is still higher than the normal level, the kidney: 6 h after injury after injury is not obvious, 1 d after injury, a slight increase, 2 d after injury, obviously after 2 d after the injury slightly lower 3 after injury slightly below the injury after the injury slightly below the lower below the lower level below the injury. The decrease was still higher than that of the normal level, and the CK-MB (241.42 + 33.31) HU/L, GPT (127.71 + 11.54) U/L, Scr (95.37 + 13.02) mol/L and the normal control group (84.12 + 12.64) HU/L, (42.28 + 11.54) U/L and (53.53 + 12.71) mu mol/L were compared, and the difference was statistically significant (t=3.327,4.081,2.508, P0.05), and severe burn combined injury group. GPT, Scr all increased obviously at 6 h after injury. The heart, liver, kidney, lung, and small intestine had pathological changes of bleeding, congestion, and inflammatory reaction. Conclusion according to the mortality of the animals in the experimental group, and the changes of the organ function and pathomorphology of the living animals, the moderate burn compound injury group is the ideal combination of burning and flushing. Animal models.

【作者单位】：哈尔滨市第五医院烧伤科;空军总医院烧伤整形科;空军总医院呼吸科;解放军总医院附属第一医院烧伤研究所;
【基金】：全军“十二五”后勤科研计划课题资助项目(CKJ12J027)
【分类号】：R644;R-332

【参考文献】