家兔轻中度肺爆震伤相关指标及早期主要死亡原因的研究

目的建立家兔轻中度单纯肺爆震伤模型,探讨伤后相关指标变化及早期主要死亡原因。方法 35只新西兰兔随机分为3组:正常对照组(A),肺爆震伤7、11cm模型组(B、C)。观察伤后动脉血气、炎性因子、肺含水量及死亡率等指标。结果 B、C组家兔伤后12h PaO2较A组明显降低(P<0.05);而伤后呼吸频率、肺含水率及炎性因子较A组均显著升高(P<0.05);伤后C组死亡率为30.77%,随着致伤距离缩短B组死亡率升高达53.85%。病理主要为弥漫性肺出血、肺实质和间质水肿及炎症细胞浸润。结论伤后早期肺出血、肺水肿及炎症反应进行性加重引起的急性呼吸功能衰竭为单纯肺爆震伤早期死亡的主要原因。

Related indicators of mild to moderate blast lung injury with rabbits and the early leading cause of death

Objective Through the establishment of the rabbit model with mild to moderate simple blast lung injury, to explore changes in relevant indicators after injury and the early leading cause of death. Methods Totally 35 New Zealand rabbits were randomly divided into three groups ： the normal control group （ A ） and the two model groups （ B, C ） , in which the blasting distance was 7 and 11 cm, respectively. Arterial blood gas, inflammatory factors,lung water content and mortality were observed. Results There was significant reduction in PaO2 in the groups B and C compared with group A 12 hours after injury（ P 〈 0.05 ）. Comparing with the normal control group, respiratory rate,lung water content, inflammatory factors of the model groups significantly increased after injury （ P 〈 0.05 ）. With diminution of the injury distance, the mortality in group B （ 53.85 % ） was more higher than that in the group C（30.77% ）. The main pathological manifestations were diffuse pulmonary hemorrhage, lung parenchyma and pulmonary interstitial edema and varying degrees of inflammatory cell invasion. Conclusion Acute respiratory failure caused by progressive exacerbation of asymmetrical pulmonary hemorrhage, pneumonedema, and inflammatory reaction is the major cause of blast lung injury.