犬穿透性胸部枪弹伤对心肺功能的影响

目的 观察犬穿透性胸部枪弹伤对心肺功能的影响，并探讨其损伤机制。方法 35只犬随机分为3组，A：胸部穿透伤组（对照组n=12），B：预扎肋间血管后致伤组n=16、C；颈扎肋间血管加人工气胸后致伤组n=7。以上3组分别用小口径步枪定点致伤右下胸，连续监测呼吸、气道压、动静脉压等，观察动物死亡情况。结果 A组死亡率为83％，B组死亡率为38％，C组无死亡，A、B组致伤后呼吸频率、气道压峰值立即明显增高，动、静脉压亦短暂性地显著升高，但仅一个波峰，随即恢复到正常水平，C组无明显变化。结论 胸部枪弹穿透伤由于心肺功能改变较重，迅即导致了循环、呼吸障碍，死亡率高，死亡原因主要为失血性休克和急性呼吸窘迫综合征（ARDS）。

Influence on the heart and lung function by penetrating thoracic gunshot wound in dogs

AIM To investigate the functional changes of the heart and lung resulting from penetrating thoracic gunshot wound in the dogs and to explore the wound mechanism. METHODS Thirty five dogs were divided randomly into 3 groups: Group A was the penetrating thoracic wounds group (control group), in group B, the intercostal artery was ligated before wound and in group C, the intercostal artery was ligated and artificial pneumothorax was made before wound. In all the groups, the gunshot wound was made with rifles at the same site point at lower right thorax. Respiration rate, airway pressure, as well as artery and vein pressure were monitored continuously. Autopsy was performed in all the experimental dogs. RESULTS Mortality rate was 83.3% in group A, 37.5% in group B, and no dogs died in group C. In both group A and B, the respiration rate, pressure peak value of airway soon increased significantly. The pressure of artery and vein temporarily increased significantly and only at one wave, then resumed immediately to the normal level. All of the above mentioned changes were insignificant in group C. CONCLUSION Mortality rate of penetrating thoracic gunshot wound is high as the wound causes severe circulatory and respiratory dysfunction. The major cause of death is hemorrhagic shock and acute respiratory distress syndrome.