兔肢体火器伤海水浸泡后伤道周围骨骼肌组织能量代谢变化特点

目的　观察兔肢体火器伤合并海水浸泡时伤道周围骨骼肌组织能量代谢变化特点,为其治疗提供确实可靠 的理论依据。方法　以高速钢珠射击兔后肢,速度为600～800m s,伤后将实验兔随机分为海水浸泡组和单致伤组。将浸 泡组兔浸泡于人工配制的海水中30min,于伤前及伤后3、6、12、24h分别切取距伤道壁0.5cm(挫伤区,A区)、1.5cm(振荡 区,B区)处组织,测定Na - K -ATP酶活性和ATP含量,以及观察超微结构。结果　海水浸泡组各区骨骼肌组织Na - K - ATP酶活性、ATP含量均呈伤后3h较伤前明显下降的趋势(P<0.01),6～12h回升,24h再次呈下降的趋势,这与病理观 察发现的挫伤区和振荡区肌组织的线粒体形态结构的动态变化时相是一致的。结论　肢体火器伤合并海水浸泡,伤后6 ～12h骨骼肌组织能量代谢有一代偿过程,为外科清创的最佳时机。

Characteristic changes of energy metabolism in skeletal muscle of rabbit limbs wounded with firearm after seawater immersion

Objective To observe the characteristic changes of energy metabolism in skeletal muscle of rabbit limbs wounded with firearm after seawater immersion. Methods The rabbit thighs were shot with high velocity steel ball and then randomly assigned into the seawater immersion (SI) group and the simple wound (SW) group. The animals in SI group were soaked in artificial seawater for 30 min and the skeletal muscle samples were taken from 0.5 cm (zone A), 1.5 cm (zone B) away from the wound tracks before and 3, 6, 12 and 24 h after trauma. The activities of Na -K -ATPase and the contents of adenosine triphosphate (ATP) were assayed. Results Na -K -ATPase activities and ATP content in the 2 zones of the skeletal muscle of SI group at 3 h after trauma decreased obviously (P<0.01) and went up form 6 to 12 h, then decreased again at 24 h as compared with those before trauma. The dynamic change of Na -K -ATPase activities and ATP content is consistent with the characteristic change of muscle tissue mitochondria. Conclusion There is a compensation course in energy metabolism of skeletal muscle of rabbit limbs wounded with firearm after seawater immersion at 6-12 h post-trauma, which is a best period of time to carry on surgical debridement.