海水浸泡开放性颅脑损伤病原菌的种类及冲洗疗法研究

目的分析海水浸泡重型开放性颅脑损伤的病原菌种类分布，并探讨冲洗疗法的治疗作用。方法将制作36只兔自由落体颅脑损伤模型创面用海水浸泡30min，然后随机等分为3组，抗生素冲洗组和生理盐水冲洗组分别用广谱抗生素和生理盐水冲洗，对照组不冲洗。海水浸泡30min（冲洗前）和伤后24h分别取脑表面细菌进行培养，观察培养结果和实验兔1周内生存时间。结果抗生素冲洗组和对照组革兰阴性杆菌培养结果差异有统计学意义。对照组生存时间显著性短于抗生素冲洗组和生理盐水冲洗组。结论海水浸泡重型开放性颅脑损伤的病原菌为多科属种细菌，主要为革兰阴性杆菌，其次为葡萄球菌。广谱抗生素冲洗能降低海水浸泡重型开放性颅脑损伤兔的颅内感染率并延长生存时间。

Pathogenic bacteria and irrigation of open craniocerebral trauma with seawater immersion

Objective To analyze the kinds and distribution of pathogenic bacteria and investigate the therapeutic effect of irrigation on severe open craniocerebral trauma with seawater immersion. Methods Weight drop craniocerebral trauma models were established in 36 rabbits, and the wound was immersed in seawater for 30 minutes. The rabbits were equally divided into three groups at random. Antibiotic irrigation group and physiological saline irrigation group were irrigated with broad-spectrum antibiotics and physiological saline respectively, while the control group was not irrigated. Bacteria from the brain surface were cultured after 30 min of immersion and 24 h post-trauma. The culture outcome and survival time in a week were observed and analyzed. Results There were significant differences in gram-negative bacillus growth between antibiotic irrigation group and control group. The survival time of control group was significantly shorter than that of other two groups. Conclusion There are many kinds and species of pathogenic bacteria on the surface of severe open cranioeerebral trauma immersed in seawater： gram negative bacilli are predominant, and staphylococcus is the second. Irrigation with broad-spectrum antibiotic solution can prolong the survival time and reduce the possibility of intraeranial infection in the rabbits with open craniocerebral trauma immersed by seawater.