彩色多普勒超声观察猪爆炸伤创面的实验研究

目的 研究爆炸伤创面的二维及彩色多普勒血流成像（CDFI）特征.方法 使用电雷管建立6头健康成年猪双侧臀部软组织爆炸伤模型,创面按左、右配对分为A、B两组.A组采用常规疗法处理,B组的消毒和清创方法同A组,创面使用封闭负压技术处理.使用彩色多普勒超声分别于伤后1 h和72 h观察两组爆炸伤创面的二维和CDFI特征.结果 伤后1 h,两组爆炸中心区均见肌束断裂,回声减低,结构紊乱,可见数个不规则的无回声区和低回声区,未探及到血流信号.伤后72 h,A组肌束排列欠规整,回声减低,可见较小无回声区和低回声区,偶见点状血流信号;B组肌肉组织回声略增强,无回声区和低回声区消失,肌束排列尚整齐,创面内可探及血流信号,部分呈＂短棒＂状.结论 二维及CDFI对观察爆炸伤创面组织结构的演变过程和了解微循环重建有重要价值;封闭负压技术对早期处理爆炸伤创面有显著的临床意义.

Experimental study on observation of pig blast trauma by color Doppler ultrasound

Objective To investigate the characteristics of blast trauma by two - dimensional ultrasound and color Doppler flow imaging （CDFI）. Methods Six adult healthy pigs were used to established blast traumas on gluteal region bilaterally by electric detonators. The traumas were divided into group A and group B according to left and right side. In group A, the trauma was treated by conventional method, while in group B, vacuum - assisted closure was applied on the wound surface. Two - dimensional ultrasound and CDFI characteristics of trauma in two groups were observed by color Doppler ultrasound after 1 h and 72 h. Results After 1 h, the muscle bundles were broken, echo was reduced, and the structure became disorder in the central area of traumas. There were several irregular districts with no or little echoes, no blood flow signal was found. After 72 h, the muscle bundles in group A was irregular with reduced echoes, punctiform blood flow signals were observed. The muscle bundles in group B were aligned regularly with increased echo, the districts with no echoes disappeared. The blood flow signal was found to be ＂short-stick＂ like. Conclusion Two - dimensional ultrasound and CDFI have important value in observation of the damage degree and successive changes of blast trauma. Vacuum - assisted closure has significant clinical value in early treatment of blast traumas.