犬胸部爆炸伤后海水浸泡的实验模型建立及早期救治结果分析

目的：建立犬海水浸泡胸部爆炸伤实验模型，探讨早期救治结果。方法：20只成年杂犬随机分为爆炸伤组（n=10)和锐器伤组（n=10)。两组动物均于致伤后浸泡在人工配制的海水中25min，而后打捞出海水环境后予以紧急救治。实验中全程监血液动力学呼吸系统和动脉血气变化。结果：海水浸泡后爆炸伤组的伤情明显重于脱器伤组，经救治后两组生存时间均明显延长，但锐器伤组更为明显。结论：本胸部爆炸伤模型是可行的并且重复性好，创伤后造成的呼吸循环功能变化与临床所见相符，适用于海水浸泡胸部开放伤的早期病理生理研究。爆炸伤的伤情更为严重，除严重电解质紊乱和高渗血症外，严重的肺损伤可能是影响生存时间的重要原因之一。

Establishment of a model of explosive open chest injury and seawater immersion and study on results of early treatment

Objective:To establish a model of explosive chest injury and seawater immersion and study on results of early treatment.Methods:Twenty health dogs were divided into two groups: explosive chest injury group and simple open pneumothorax group. A explosive model of open chest injury was established with lower dose of TNT. The animals in both groups were immersed into seawater after chest injury. Blood samples were taken at eight different time intervals for assessing blood gas, serum osmotic pressure and serum electrolytes. The hemodynamic and respiratory changes were recorded. At the end of study lung was harvested for pathologic examination.Results:Post trauma condition in explosive chest injury group was more serious than that in simple open pneumothorax group. After acute treatment survival time in both groups were significantly longer, especically in simple open pneumothorax group.Conclusion:The results of this study indicates that the explosive model of chest injury is practicable and can be repeated well. The physiopathologic changes of hemodynamic and respiratory system are similar to that of humen chest injury. These risky factors appear to be associated with severe serum normal saline metablism imbalance and higher osmotic pressure which resulting from seawater immersion in both groups. But the higher risky in explosive group may related to severe acute lung injury.