弹烧复合伤合并海水浸泡对血管内皮细胞止血功能的影响

发布时间：2018-08-19 16:02

【摘要】：目的　探讨弹烧复合伤合并海水浸泡对血管内皮细胞止血功能影响的原因和机制。方法　建立弹烧复合伤的犬实验模型 ,致伤后将犬随机分为非浸泡组和浸泡组 ,将浸泡组犬在海水中浸泡 4h后捞出 ,然后于伤后 4、7、10、2 0、2 8h分别取血检测循环内皮细胞 (circulatingendothelialcells ,CEC)、以及组织型纤溶酶原激活剂 (tissue typeplasminogenacti vator ,t PA)、纤溶酶原激活剂抑制物 (plasminogenactivatorinhibitor 1,PAI 1)、血栓素B2 (thromboxaneB2 ,TXB2 )和 6 酮前列腺素1α( 6 keto prostaglandinF1α,6 K PGF1α)比值的变化 ,并且于伤后 2 8h活杀犬 ,取肺组织行病理检查。非浸泡组除不浸泡海水外 ,余检测时相及指标同浸泡组。结果　非浸泡组于伤后 4h和 7hCEC、PAI 1、TXB2 6 K PGF1α均升高 (P 0 0 5 ) ,t PA降低 (P 0 0 5 ) ,而浸泡组于伤后 4、7、10、2 0、2 8hCEC、PAI 1和TXB2 6 K PGF1α均持续增高 (P 0 0 5或P 0 0 1) ,t PA持续降低 (P 0 0 1) ;组间比较 :浸泡组从伤后 4h至伤后 2 8h ,各指标均与非浸泡组有显著差异 (P 0 0 5或P 0 0 1)。光镜下可见肺血管中血栓形成。结论　弹烧复合伤合并海水浸泡后可引起全身EC急性损伤以及造成EC止血功能紊乱 ,从而导致血栓形成 ,
[Abstract]:Objective to investigate the effect of combined bullet burn injury and seawater immersion on hemostatic function of vascular endothelial cells (VEC). Methods the canine model was established. The dogs were randomly divided into two groups: the non-immersion group and the immersion group. The dogs in the immersion group were soaked in seawater for 4 hours. Then, blood samples were taken for the detection of circulating endothelial cells (circulatingendothelialcells), tissue plasminogen activator (tissue typeplasminogenacti vator) PA), plasminogen activator inhibitor (plasminogenactivatorinhibitor 1), thromboxane B 2 (thromboxaneB2 TXB2) and pre-6 ketone respectively. The change of the ratio of adenine 1 伪 (6 keto prostaglandinF1 伪 to 6 K PGF1 伪), The dogs were killed alive at 28 hours after injury, and the lung tissues were taken for pathological examination. The phase and index of the non-immersion group were the same as those of the immersion group. Results in the non-immersion group, the levels of TXB26 K PGF1 伪 increased at 4 h and 7 h after injury (P < 0.05), and the levels of TXB26 K PGF1 伪 decreased (P 0.05). In the immersion group, CECU PAI 1 and TXB2 6 K PGF1 伪 increased continuously at 28 h after injury (P 0 05 or P 0 01), and the levels of t PA in the immersion group were decreased (P 0 01), the comparison between the groups: from 4 h after injury to 28 h after injury. There were significant differences between the two groups (P 0 05 or P 0 01). Thrombosis in pulmonary vessels is visible under light microscope. Conclusion the combined injury of projectile and burn combined with seawater immersion can cause acute injury of EC and hemostatic dysfunction of EC, which leads to thrombosis.
【作者单位】：第三军医大学大坪医院野战外科研究所麻醉科第三军医大学大坪医院野战外科研究所第六研究室创伤烧伤复合伤国家重点实验室第三军医大学大坪医院野战外科研究所麻醉科
【基金】：全军“十五”指令性课题 ( 0 1L0 11)~~
【分类号】：R82

【参考文献】