可控性脊髓爆震伤模型的建立及相关研究

发布时间：2018-09-03 20:31

【摘要】：现代化战争的新特点是传统的枪弹贯通伤明显减少，炸弹爆炸后形成的冲击波损伤数量明显增加。尽管伤后的主要死亡原因集中在胸腔、腹腔、颅脑等重要脏器的损伤上，但是存活下来的伤员中，有大量因冲击波造成的脊髓损伤。本课题在前期研究的基础上，着重探讨冲击波作用于脊髓表面导致损伤的超压范围，在建立相关动物模型的基础上进一步观察脊髓爆震伤后的组织学变化。目的：建立一种新的冲击波损伤实验动物模型，使冲击波直接作用到脊髓表面，造成脊髓损伤，排除皮肤、软组织、骨骼对冲击波的干扰，研究冲击波损伤后脊髓相应的病理生理变化，为早期治疗提供理论依据。方法：（1）采用10g的单质锰炸药（RDX）为水下爆源，电控引爆，测量不同距离的冲击波强度；（2）将18只大鼠分为3组，每组6只，切除大鼠T9-10段椎板，暴露脊髓，将暴露的脊髓正对冲击波的传导方向，按照距离爆源0.3、0.8、1.5米实施水下爆破，检测不同爆炸距离下的瞬时超压峰值、冲击波的正压作用时间，观察大鼠存活及组织损伤情况，观察伤后24小时脊髓损伤功能评分；（3）在1.5米距离下实施爆炸，将30只大鼠随机分为空白对照组和实验组。对照组（n=6）不给于爆震损伤处理，统一于7d取材。实验组分别于损伤后8h（n=6）、1d（n=6）、3d（n=6）、7d（n=6）、取材；取材后通过HE染色、透射电镜检测等技术，观察爆震伤对脊髓的影响。结果：（1）爆炸后冲击波致使实验动物死亡的主要原因是：重要脏器损伤导致的呼吸、循环衰竭。首要原因是肺挫伤造成的呼吸衰竭；（2）爆炸源为10g的单质锰炸药，在距离爆源1.5米处产生3Mpa强度的冲击波，伤后实验动物完全成活，损伤平面以下出现运动、感觉障碍，脊髓损伤功能评分符合实验要求；（3）伤后光镜下观察，，损伤段脊髓组织可见大量散在的出血坏死灶，以灰质范围内出血坏死较重，出现时间较早，灰质内神经元数目明显减少，白质内脱髓鞘样改变严重。伤后透射电镜的观察可见神经元细胞核体积减小，内褶皱形成，线粒体、内质网等细胞器肿胀严重，数量明显减少；髓鞘板层出现明显的断裂和崩解，轴浆内细胞器减少，神经丝断裂；灰质内发现大量的红细胞，并伴有明显的坏死区形成。结论：水下可控性脊髓爆震伤模型精确性和稳定性好，该模型排除了皮肤、软组织、骨骼的干扰，使冲击波直接作用于脊髓表面，实现了单纯冲击波因素致伤的特点，为今后的实验提供了良好的动物模型。
[Abstract]:The new characteristic of modern war is that the traditional bullet penetrating injury is reduced obviously and the number of shock wave damage caused by bomb explosion is obviously increased. Although the main causes of death after the injury are chest abdominal cavity craniocerebral and other important organ injuries but the survival of the injured there are a large number of spinal cord injury caused by shock wave. On the basis of previous studies, this paper focuses on the range of overpressure caused by shock wave acting on the surface of spinal cord, and further observes the histological changes after spinal cord explosive injury on the basis of the establishment of related animal models. Objective: to establish a new animal model of shock wave injury, which directly acts on the surface of spinal cord, resulting in spinal cord injury and eliminating the interference of skin, soft tissue and bone on shock wave. To study the pathophysiological changes of spinal cord after shock wave injury and to provide theoretical basis for early treatment. Methods: (1) using 10 g (RDX) as the underwater detonation source, electrically detonating and measuring the shock wave intensity at different distances, 18 rats were divided into 3 groups, 6 rats in each group, and the spinal cord was exposed by excising the lamina of the T9-10 segment of the rats. According to the conduction direction of the exposed spinal cord to the shock wave, underwater blasting was carried out according to the distance of 0.3 ~ 0.81.5 meters from the explosion source. The instantaneous overpressure peak at different explosion distances and the time of positive pressure action of the shock wave were detected, and the survival and tissue damage of the rats were observed. The functional score of spinal cord injury was observed 24 hours after injury. (3) explosion was carried out at a distance of 1.5 meters, and 30 rats were randomly divided into blank control group and experimental group. The control group (NX 6) was not treated with knock damage, but was collected at 7 d. The experimental group was collected at 8 h (NX 6) and 1 d (ng 6) 3 d (ng 6) and 7 d (ng 6), and the effects of blast injury on spinal cord were observed by HE staining and transmission electron microscopy (TEM). Results: (1) the main causes of death caused by shock wave after explosion were respiratory and circulatory failure caused by injury of important organs. The primary cause was respiratory failure caused by lung contusion. (2) the blast source of 10 g of simple manganese explosive produced shock waves of 3Mpa strength at a distance of 1.5 meters from the detonation source. After the injury, the experimental animals survived completely, and there were movement and sensory disorders below the injury plane. The functional score of spinal cord injury meets the requirements of the experiment. (3) under the light microscope, a large number of scattered hemorrhage and necrosis foci were observed in the injured spinal cord tissue, with severe hemorrhage and necrosis in the gray matter area, earlier occurrence time, and a significant decrease in the number of neurons in the gray matter. The demyelinating changes in white matter were severe. The results of transmission electron microscopy showed that the nucleus volume was reduced, the inner fold formed, mitochondria and endoplasmic reticulum were swollen, and the number of organelles was decreased, the myelin sheaths were broken and disintegrated, and the organelles in axon cytoplasm were decreased. A large number of red blood cells were found in gray matter with obvious necrotic areas. Conclusion: the model of underwater controllable spinal cord explosive injury is accurate and stable. The model eliminates the interference of skin, soft tissue and bone, and makes the shock wave act directly on the surface of spinal cord. It provides a good animal model for future experiments.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R82

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