舱内爆炸大鼠血液动力学的早期变化

发布时间：2018-05-26 18:26

本文选题：舱室内爆炸 + 冲击波烟雾复合伤　；参考：《中国组织工程研究与临床康复》2008年50期

【摘要】：背景:已证实冲击波和烟雾均可引起机体显著的血流动力学紊乱,但对冲击波烟雾复合伤时血流动力学特点少有文献报道。目的:探讨舱室内爆炸复合有害气体对大鼠血流动力学早期变化的影响,评价脑钠肽做为冲击波烟雾复合伤早期检测损伤指标的可行性。设计、时间及地点:随机分组,动物实验观察,于2006-08/2007-08在解放军第三军医大学大坪医院野战外科研究所完成。材料:纳入健康雄性SD大鼠104只,随机分为3组:正常对照组8只,爆炸损伤组48只,复合损伤组48只。方法:将大鼠按模拟战位固定于模拟舱室内,0.4g黑索金点纸质爆源置于舱室中心爆炸,模拟冲击波烟雾复合伤模型。复合损伤组大鼠在爆炸后放置100s取出,爆炸损伤组大鼠爆炸后立即取出,正常对照组不做处理。主要观察指标:大鼠于伤后1,3,6,12,24,72h再次麻醉后行动脉插管观察心功能变化,并采血,运用双抗体夹心法检测血浆脑钠素蛋白水平,取心脏病理标本观察心肺组织病理变化。结果:与正常对照组比较,爆炸损伤组和复合损伤组大鼠心肺病理形态学,均有明显改变,且复合损伤组比爆炸损伤组损伤严重。爆炸损伤组和复合损伤组大鼠血浆脑钠肽在各时相点均高于正常对照组(P0.05),复合损伤组高于爆炸损伤组(P0.05)。左室内压最大下降速率、左室收缩压、平均动脉压与脑钠肽质量浓度的变化一致,而左室内压最大上升速率则呈负相关性。结论:脑钠肽可做为冲击波烟雾复合伤早期检测损伤指标,舱内爆炸烟雾复合伤对心肺损伤较单纯爆炸损伤更加严重。
[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.
【作者单位】：解放军第三军医大学大坪医院神经外科;
【基金】：全军“十一五”医学科研基金(06Z034)~~
【分类号】：R826

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