水下冲击波的物理参数特征和冲击伤的形态学变化

发布时间：2019-04-24 22:19

【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。
[Abstract]:Objective: to investigate the pathomorphological changes of underwater blast injury. Methods: 61 adult mongrel dogs and 8 goats were subjected to underwater blast injury induced by 200500 and 1000gTNT underwater explosion. The physical parameters of shock wave were measured by PCB underwater explosion pressure sensor. The survival and pathomorphology of blast injury were observed 6 hours after injury. Results: the physical parameters of underwater shock wave were characterized by high peak pressure, short positive duration and high impulse. Among 61 dogs, 23 dogs died, the mortality rate was 37.7% (23 / 61), and 2 out of 8 goats died. Morphological observation found that the incidence of lung injury was the highest, followed by gastrointestinal injury, a few animals can occur liver and spleen and other substantive organ injury, while bladder and gallbladder and other liquid organs rarely occur. The main manifestations of lung injury are different degrees of pulmonary hemorrhage, severe lung edema, even hemorrhagic bullae and lung tear. The main manifestations of gastrointestinal injury were subserous hemorrhage, subserous hematoma and serous muscle layer tear in some animals, and even perforation of gastrointestinal tract. Liver and spleen and other parenchyma organs can be seen subcapsular hemorrhage, haematoma, severe liver and spleen rupture. The morphological changes were related to the physical parameters of shock wave. The higher the impulse, the higher the incidence rate and the severity of injury. Conclusion: underwater blast injury is characterized by severe injury and high mortality. The treatment of acute respiratory distress gastrointestinal perforation and internal hemorrhage caused by parenchymal organs should be strengthened in early treatment.
【作者单位】：解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室解放军第三军医大学大坪医院野战外科研究所四室
【基金】：军队“十五”指令性课题(01L067)~~
【分类号】：R82

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