犬海水中火器伤细菌感染定量研究

发布时间：2019-08-01 13:04

【摘要】：目的定量探讨海水中火器伤伤道组织细菌增殖的变化规律及发生感染的时限,为进一步研究这一特殊环境下火器伤组织清创时机、方法及抗生素应用提供依据。方法将16条犬随机分为海水中致伤组与地面致伤组,海水组14只,地面组2只;于火器伤后0、6、12、24 h进行大体观察及细菌学定量检测。对测得结果进行统计学分析,并建立火器伤组织中细菌增殖动力学模式。结果两组伤犬伤道单位组织中的细菌数均随时间的延长而递增,且海水组同一时间点的细菌数均比地面组高,击伤即时的细菌污染程度较地面组重,6 h时已达感染临界。两组组织中细菌生长的动力学模式可用下式概括: Y(1) = 9.12×10(3+0.247X), Y(2) = 1.35×10(3+0.227X)。式(1)、(2)分别为海水组和地面组火器伤组织中细菌生长的动力学模式,为每克组织中的细菌含量(个/g),X为火器伤伤后时相。根据这一模式,我们计算得到海水组和地面组达到感染临界时所需的时间分别为4.2和8.2 h,海水组达到感染临界状态比地面组提前4 h。结论海水中火器伤较地面火器伤污染重、损伤重,细菌繁殖快,感染出现早,应及早清创、彻底冲洗伤道和及时应用抗生素,这些治疗措施应以在4 h之内完成为宜。
[Abstract]:Objective to quantitatively investigate the changes of bacterial proliferation and the time limit of infection in gunshot wound tissue in seawater, and to provide evidence for further study on the time, method and application of antibiotics in the debridement of gunshot wound tissue in this special environment. Methods Sixteen dogs were randomly divided into seawater injury group (n = 14) and ground injury group (n = 2). Gross observation and bacteriological quantitative detection were carried out at 0, 6, 12 and 24 hours after firearm injury. The results were statistically analyzed and the kinetic model of bacterial proliferation in gunshot wound tissues was established. Results the number of bacteria in the unit tissue of the injured dogs in the two groups increased with the prolongation of time, and the number of bacteria in the seawater group was higher than that in the ground group at the same time point, and the degree of bacterial contamination in the immediate injury group was heavier than that in the ground group, and reached the critical level of infection at 6 hours. The kinetic model of bacterial growth in the two groups can be summarized by the following formula: Y (1) = 9.12 脳 10 (30.247X), Y (2) = 1.35 脳 10 (30.227X). The formula (1), (2) was the kinetic model of bacterial growth in gunshot wound tissues of seawater group and ground group, respectively, and the bacterial content per gram of tissue (per gram / g), X) was the phase after firearm injury. According to this model, we calculated that the time required for the seawater group and the surface group to reach the infection criticality was 4.2 h and 8.2 h, respectively, and that the seawater group reached the critical state of infection 4 h earlier than that of the ground group. Conclusion the pollution of firearm injury in seawater is more serious than that of firearm wound on the ground, the bacterial reproduction is fast, the infection appears early, the wound passage should be thoroughly washed and antibiotics should be used in time. These treatment measures should be completed within 4 hours.
【作者单位】：第一军医大学病理学教研室第一军医大学病理学教研室珠海市公安局卫生局第一军医大学病理学教研室第一军医大学病理学教研室第一军医大学病理学教研室第一军医大学流行病学教研室
【基金】：全军医学科研“十五”计划项目(01MA126)~~
【分类号】：R826.3

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