高温高湿环境肢体火器伤细菌学改变的研究

目的 :为高温高湿环境下火器伤后软组织清创的时机、方法及抗生素的应用提供依据。方法 :将犬随机分为高温高湿 (HHE)组和常温常湿 (OE)组 ,于火器伤后 0、4、6、8、12、2 4h进行大体情况、细菌学定量和定性变化等指标的检测。结果 :伤肢肿胀、组织坏死和动物死亡时间 ,HHE组均较OE组提前及严重。细菌学定量检测HHE组火器伤伤道细菌数在同一时间点比OE组高 ,OE组 12h细菌数目达到可引起感染的临界数值 ,而HHE组 8h时细菌数即达临界数值。细菌定性检测 ,两组弹道局部均为表面菌群 ;血液中OE组只有表面菌群 ,HHE组除表面菌群外还有肠道菌群。结论 :高温高湿环境下火器伤后细菌繁殖快 ,感染时间提前且严重 ,肠道细菌容易入血 ,因此处理更应强调尽早、彻底的清创和早期使用广谱抗生素

BACTERIOLOGICAL STUDY OF GUNSHOT WOUND ON LIMBS OF DOGS IN HOT AND HUMID ENVIRONMENT

Objective:To provide the reference data for the time and methods of debridement and the application of antibiotics in hot and humid environment.Methods:Eight dogs were divided into two groups at random:hot and humid environment (HHE) group and ordinary environment (OE) group. At 0,4,6,8,12,24 h after wound, gross condition and bacteriological quantity and strains were observed.Results:Swelling of limbs,necrosis of tissue and time to death in dogs of HHEgroup were all earlier and more serious than those in OE group. The bacteriological quantity in wound tract of HHE group was higher than that of OE group at the same time point. The number of bacteria got up to the critical point of infection at 12 h in OE group, but at 8 h in HHE group. In wound tracts there were exterior strains in both groups. The bacteria in blood were exterior strains in OE group, while exterior and intestinal strains in HHE group.Conclusion:In hot and humid environment, the bacteria in the wound tracts proliferated more rapidly than that in ordinary environment, and earlier and more serious infection was apt to occurring with intestinal strains entering into the blood. Therefore early and complete debridement of gunshot wound and the application of broad-spectrum antibiotics should be emphasized in hot and humid environment.