摘要
背景:颅脑火器伤是战时常见的严重创伤,而环境因素是加剧病情发展、早期危及伤病员生命的重要因素。开展高温高湿环境下颅脑火器伤基础与救治研究是军事医学的重要课题。目的:观察高温高湿环境下猫颅脑火器伤后创腔及周围组织细菌生长特点,为颅脑火器伤组织修复及其功能恢复提供参考。设计:随机对照实验。单位:南方医科大学(原第一军医大学)附属珠江医院神经外科。材料:实验于2003-04/05在南方医科大学热带医学与卫生系实验室完成。实验选取清洁级杂种猫24只。雌雄不限,体质量(2.5±0.2)kg,由南方医科大学实验动物中心提供。将实验动物随机分为4组:常温火器伤对照组5只;常温火器伤组8只;高温高湿火器伤组8只;空白对照组3只。方法:将猫称重后用30g/L戊巴比妥钠液按30mg/kg行腹腔注射。构建颅脑盲管伤模型,待模型成立后,常温火器伤组伤后置于25℃、相对湿度50%的仿真模拟气候舱中6h,高温高湿火器伤组置于35℃、相对湿度为85%的高温高湿环境中6h。按活检法分别取伤道内碎裂脑组织,伤道壁0～5mm和5～10mm的脑组织,称重后配制成原液和匀浆液,培养24h后计数,并计算创腔及周围组织细菌含量。空白对照组麻醉致死后直接取材,其余步骤同常温火器伤对照组。主要观察指标:各组创腔及周围组织细菌含量。结果:23只动物纳入结果分析。相同部位细菌含量因分组不同而有明显性差异(F=171.423,P=0.000)。两两比较显示常温火器伤对照组、常温火器伤组、高温高湿火器伤组与空白对照组之间差异有显著性意义(P<0.01),而常温火器伤对照组、常温火器伤组和高温高湿火器伤组之间比较差异无显著性(P>0.05)。各组内距创腔距离的不同细菌含量亦有明显差异(F=14.865,P=0.000)。结论:高温高湿环境对颅脑火器伤6h内的细菌生长情况无显著影响,细菌繁殖未进入高速增长期,进行清创性修复仍是安全的。
BACKGROUND：Crainocerebral missile wound （CMW） is the common severe trauma of war. Environmental factor is the important factor that aggravates the development of sickness and threatens the life of the sick and wounded at early stage. The study on basic theory and treatment of CMW under hyperthermia and high-humidity is the major task in military medicine. OBJECTIVE： To observe the characters of bacterial growth in wound cavity and peripheral tissue after CMW in cats under hyperthermia and high-humidity so as to provide the reference data to the tissue repair and its functional recovery in CMW. DESIGN： Randomized controlled experiment. SETTING： Surgery Department of Neurology in Zhujiang Hospital affiliated to Southern Medical University（First Military Medical University）. MATERIALS： The experiment was performed in Department of Tropical Medicine and Hygiene in Southern Medical University from April to May 2003. In the experiment, 24 hybrid cats were employed, of clean grade, of either sex, body-weighted （2.5±0.2） kg, provided from Experimental Animal Center of Southern Medical University. The animals were randomized into 4 groups, named the control at common temperature （5 cats）, common temperature group （8 cats）, hyperthermia and high-humidity group （8 cats） and blank control （3 cats）. METHODS： After weighted, the cat was injected abdominally with 30 g/L pentobarbitol sodium solution at 30 mg/kg. After successful establishment of cranioeerebral blindgut wound model, in common temperature group, the cats were placed in simulated climatic cabin at 25℃ and 50% relevant humidity for 6 hours and in hyperthermia and high-humidity group, the cats were placed in the hyperthermia and high-humidity environment for 6 hours. With biopsy, the fragmented brain tissue in wound tract and the brain tissue on the wall of wound tract far from 0-5 mm and 5-10 mm were collected and prepared into successively natural solution and homogenate, and counting was done in 24 hours of bacterial culture to calculate bacterial content in wound cavity and peripheral tissue. In blank control, the cats were sacrificed with anesthesia and the material was collected directly, the rest steps were same as the control at common temperature. MAIN OUTCOME MEASURES： Bacterial content in wound cavity and peripheral tissue in each group. RESULTS： Totally 23 animals were employed in outcome analysis. Bacterial contents in same regions were different remarkably in different groups （F=171.423, P=0.000）. It was indicated in paired comparison that significant difference happens between the control at common temperature, common temperature group and hyperthermia and high-humidity group and blank control successively （P 〈 0.01）. The difference was not significant in the comparison among the control at common temperature, common temperature group and hyperthermia and high-humidity group （P 〉 0.05）. Bacterial contents at different distances from the wound cavity were different remarkably in each group （F=14.865, P = 0.000）. CONCLUSION： Hyperthermia and high-humidity does not impact significantly the bacterial growth of CMW in 6 hours and bacterial reproduction has not entered high-rate increasing stage yet, due to which, it is still safe for debridement repair.
出处
《中国临床康复》
CSCD
北大核心
2006年第12期187-189,共3页
Chinese Journal of Clinical Rehabilitation
基金
军队"九五"军事医学科研课题(96M067)~~
