摘要
目的观察猪胸部撞击伤,胸腔内不同部位压力响应特点及其与肺损伤的关系。方法健康小型猪6只,经外科手术在右侧胸腔不同部位放置生物压力传感器,待动物情况稳定后,利用B IM-Ⅱ型水平撞击机对右侧胸壁进行撞击致伤,撞击头接触面积20 cm2,撞击速度为19m/s,撞击压缩比为8%和15%,分别记录和分析胸腔不同位置的压力响应曲线,伤后6小时解剖观察肺损伤情况。结果7、8肋间靠近脊椎处正压峰值和正压积分值显著高于其他部位(P<0.01),15%压缩比组分别达到(67.6±7.7)kPa和(140.4±20.2)kPa.m s,肺门近心包处压力峰值和其积分值次之;15%压缩比组中5、6肋间隙中线处、膈肌中线处与肺门近心包处的正压峰值与正压积分显著高于8%压缩比组(P<0.01)。大体解剖发现8%压缩比组未见明显肺损伤,15%压缩比组右肺下叶背侧面有弥漫性出血区,背侧第7肋附近出现条状肺出血。结论19m/s撞击时,猪右侧胸腔内不同部位的压力响应有显著差异;高压缩比撞击下,右肺下叶背侧面与肺门近心包处压力峰值和压力积分值高且肺损伤较重;5、6肋间隙中线、膈肌中线和肺门近心包等部位的压力响应与撞击压缩比显著相关。
Objective To study features of the pressure response in different regions in the thorax after an impact at 19m/s upon the right side of the chest of miniature swine. Methods Six healthy adult miniature swine were selected. Small pressure-biosensors were planted in different positions in the right thorax after thoracotomy. When the vital signs were stabilized,the right side of the chest was impacted by BIM-Ⅱ Horizontal Bio-impactor,with an area of contact of 20cm^2 and a velocity of 19m/s. The pressure-responding curves of different positions in the thorax were recorded and analyzed. Results The peak value of positive pressure and the integral of positive pressure obtained near the vertebrae at the 7th intercostal were statistically and significantly higher than other region （P 〈 0. 01 ）. In the group of compression ratio of 15% ,it reached （67.6 ± 7.7）kPa and （ 140.4 ± 20.2）kPa · ms respectively in the group of compression ratio of 15%. The peak value of positive pressure and the integral of positive pressure of the pericardium near hilus of lung was just smaller than the region that near the vertebrae at the 7th intercostal. The peak value of positive pressure and the integral of positive pressure at the middle line of 5th intercostal level,diaphragmatic midline and the pericardium near hilus of lung at the 15% were statistically and significant raised than the compression ratio of 8% （ P 〈0.01 ）. Results of autopsy revealed diffuse hemorrhage at dorsal surface of inferior lobe of right lung and stripes of lung hemorrhage near the 7th costal bone in the group with 15% compression ratio,but no marked pulmonary injury was found in the group with 8% compression ratio. Conclusion Pressure responses at different positions in the thorax differ significantly at 19m/s impact upon the right thorax of miniature swine. There is higher value of the positive pressure peak and the positive pressure integral obtained in inferior lobe of right lung and pericardium near hilus of lung,furthermore,this region revealed severe hemorrhage and lung injury. The pressure response of the middle line of 5th intercostal level,diaphragmatic midline and the pericardium near hilus of lung is statistically significant correlated with compression ratio.
出处
《创伤外科杂志》
2005年第5期360-363,共4页
Journal of Traumatic Surgery
基金
国家自然科学基金资助项目(30122201)
关键词
胸部撞击伤
压力响应
肺损伤
猪
chest impact trauma
pressure response
lung injury
miniature swine
