颌面部爆炸伤(弹冲复合伤)致肺损伤的实验研究

目的探讨颌面部爆炸伤时肺损伤的情况及其致伤机制.方法采用瞬发纸质电雷管、“五三”式滑膛枪以及同步测速及测压系统,建立口腔颌面部爆炸伤模型,造成犬颌面部弹(片)冲击复合伤.记录致伤参数,观察动物伤情及肺组织的病理变化.结果所有动物颌面部损伤均为咬肌区软组织切线伤,胸部压力波超压值平均63.7kPa,并未见明显损伤.伤后动物呼吸浅快,肺组织损伤严重,表现为肺组织的瘀血、水肿,以及大量中性粒细胞浸润,以左肺上叶明显.结论颌面部弹(片)冲复合伤时可并发肺组织的严重损伤,高速破片及爆炸冲击波的复合作用可能为其致伤机制.

Study on the blast injury of lung combined with explosive injury in maxillofacical region

Objective To study the characteristics and the mechanism of lung injury combined with explosive injury in maxillofacical region.Methods The detonator,steel spheres as fragments simulants shot by sm ooth bore barrel and synchoronizer were used to define the wound model and the left maxillofacial region of dogs were used as targets.Wounding parameters were recorded.The changes of targets and the lungs were observed after explosion.Results After wounding,the local trauma of dogs was very serious with combined blast injuries of lungs.The mean peak value of the blast wave was 63.7 kPa.The rupture of alveoli and small blood vessels,the haemor rage and oedema of lung injury were observed post trauma,especially at the superior lobe of left lung.Also,many neutrophils infiltrated into the wounds at 24h after trauma.Conclusions The heavy lung injury can be combined with the explosive injury of maxillofcial region.High velocity fragments together with blast wave are the factors of this injury.