犬多发伤合并海水浸泡的早期综合救治

目的：观察犬多发伤合并海水浸泡救治前后水、电解质变化，探讨犬多发伤早期综合救治方案。方法：成年杂种犬20只，制作多发伤动物模型。随机分为多发伤救治组(n=10)：海水浸泡1h后打捞出水救治；对照组(n=10)；海水浸泡1h打捞出水后不予救治。救治组在补液、复温同时行破裂小肠一期切除吻合术和右下肢软组织爆炸伤清创术，观察救治前后水、电解质、酸碱平衡的改善情况，体温变化和术后吻合口并发症及犬存活情况。结果：多发伤合并海水浸泡犬水、电解质、酸碱平衡紊乱和体温过低于救治后4--6h得以纠正，小肠吻合口并发症低，1周存活率为80％；对照组水、电解质、酸碱平衡紊乱和体温过低在打捞出水后继续加重，全部于6h内死亡，死亡率为100％。结论：对多发伤合并海水浸泡应实施早期综合救治，可同时行破裂小肠一期切除吻合术和软组织爆炸伤清创术。

Primary small bowel anatomy after intestinal rupture injury and seawater immersion

Objective To observe the physiopathologic changes after multiple injuries and seawater immersion and discuss the early treatment plan for multiple injuries.Methods 20 adult health dogs were subjected to open abdominal injury,intestinal rupture injuries and parenchyma injury on right thigh.All the animals were divided into two groups randomly after seawater immersion for 1 hour.Group A(n=10) were rescued with the early treatment plan after seawater immersion.Group B(n=10) had no treatment.The changes of survival rate,temperature,body liquid metabolism and complication rates were observed respectively.Results A resuscitation plan was drew up with liquid treatment and warming treatment for body liquid metabolism disorder and hypothermia.The disorders were improved obviously after 4 to 6 hours'treatment.The survival rate and complication rate of group A were 80% and 40% after small bowel anatomy and debridement for parenchyma injury on right thigh.All the animals in control group had no improvement on disorder of body liquid metabolism and hypothermia and died during 6 hours after out of seawater.Conclusion The resuscitation plan which included liquid treatment,warming treatment,primary small bowel anatomy and debridement for parenchyma injury was efficacious and practical for early treatment of multiple injuries after seawater immersion in dogs.