中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2010年
4期
366-369
,共4页
高志明%张岫竹%王旭辉%何跃%刘大维%张良%王伍超%代维%蔡双霜%张良潮%林井副%周继红
高誌明%張岫竹%王旭輝%何躍%劉大維%張良%王伍超%代維%蔡雙霜%張良潮%林井副%週繼紅
고지명%장수죽%왕욱휘%하약%류대유%장량%왕오초%대유%채쌍상%장량조%림정부%주계홍
坐骨神经%创伤,枪击%猪
坐骨神經%創傷,鎗擊%豬
좌골신경%창상,창격%저
Sciatic nerves%Wounds,gunshot%Swines
目的 探讨高速三角破片致猪坐骨神经损伤的伤情特点. 方法 长白猪14只,体重(34.3±5.2)kg.采用随机数字表法分为A、B两组各7只,用初速为(773.1±12.4)m/s的0.37 g三角破片致伤,分别瞄准猪右后肢外侧坐骨神经体表投影线中点和旁开2 cm射击.观察伤道入口和出口大小、长度,神经与伤道位置关系,伤后48 h观察神经大体及光电镜改变. 结果 破片在伤道内存在不同程度的偏离原射入方向.A、B组分别有5只和1只坐骨神经位于原发伤道内,其中4例出现不间程度断裂;光镜下见神经严重出血水肿、炎细胞浸润,大量神经纤维、轴索断裂,髓鞘着色浅;电镜下见髓鞘严重溃变、轴索变形.A、B组分别有1只和5只位于震荡区内,距原发伤道(2.07±0.45)cm,光镜见神经轻度出血、充血,部分神经纤维、轴索断裂;电镜下可见髓鞘部分分层.A、B组各有1只位于挫伤区内,神经受损程度介于二者之间. 结论 高速三角破片在组织内走行不稳定;其原发伤道内的猪坐骨神经断裂发牛率高,损伤严重,范围广,华勒变性早;位于原发伤道旁的神经亦发生形态学改变,其损害程度与神经和原发伤道距离有关.
目的 探討高速三角破片緻豬坐骨神經損傷的傷情特點. 方法 長白豬14隻,體重(34.3±5.2)kg.採用隨機數字錶法分為A、B兩組各7隻,用初速為(773.1±12.4)m/s的0.37 g三角破片緻傷,分彆瞄準豬右後肢外側坐骨神經體錶投影線中點和徬開2 cm射擊.觀察傷道入口和齣口大小、長度,神經與傷道位置關繫,傷後48 h觀察神經大體及光電鏡改變. 結果 破片在傷道內存在不同程度的偏離原射入方嚮.A、B組分彆有5隻和1隻坐骨神經位于原髮傷道內,其中4例齣現不間程度斷裂;光鏡下見神經嚴重齣血水腫、炎細胞浸潤,大量神經纖維、軸索斷裂,髓鞘著色淺;電鏡下見髓鞘嚴重潰變、軸索變形.A、B組分彆有1隻和5隻位于震盪區內,距原髮傷道(2.07±0.45)cm,光鏡見神經輕度齣血、充血,部分神經纖維、軸索斷裂;電鏡下可見髓鞘部分分層.A、B組各有1隻位于挫傷區內,神經受損程度介于二者之間. 結論 高速三角破片在組織內走行不穩定;其原髮傷道內的豬坐骨神經斷裂髮牛率高,損傷嚴重,範圍廣,華勒變性早;位于原髮傷道徬的神經亦髮生形態學改變,其損害程度與神經和原髮傷道距離有關.
목적 탐토고속삼각파편치저좌골신경손상적상정특점. 방법 장백저14지,체중(34.3±5.2)kg.채용수궤수자표법분위A、B량조각7지,용초속위(773.1±12.4)m/s적0.37 g삼각파편치상,분별묘준저우후지외측좌골신경체표투영선중점화방개2 cm사격.관찰상도입구화출구대소、장도,신경여상도위치관계,상후48 h관찰신경대체급광전경개변. 결과 파편재상도내존재불동정도적편리원사입방향.A、B조분별유5지화1지좌골신경위우원발상도내,기중4례출현불간정도단렬;광경하견신경엄중출혈수종、염세포침윤,대량신경섬유、축색단렬,수초착색천;전경하견수초엄중궤변、축색변형.A、B조분별유1지화5지위우진탕구내,거원발상도(2.07±0.45)cm,광경견신경경도출혈、충혈,부분신경섬유、축색단렬;전경하가견수초부분분층.A、B조각유1지위우좌상구내,신경수손정도개우이자지간. 결론 고속삼각파편재조직내주행불은정;기원발상도내적저좌골신경단렬발우솔고,손상엄중,범위엄,화륵변성조;위우원발상도방적신경역발생형태학개변,기손해정도여신경화원발상도거리유관.
Objective To study the characteristics of the sciatic nerve injuries inflicted by highvelocity triangle fragments in swine.Methods According to the injury position,14 swines weighing (34.29±5.2)kg were divided into two groups.All swines were shot by 0.37 g triangle fragments at (773.1±12.4)m/s aimed at the midpoint of the lateral body surface projection of the right sciatic nerve in Group A(n=7)and at 2 cm aside from sciatic nerve in Group B(n=7).The entrance,exit and length of wound tract,distance between nerve and wound tract were detected,and the pathology of sciatic nerve and wound tract at 48 hours after injury were observed under light microscope and electron microscope.Results The course of the fragments was deviated to different extent.Six sciatic nerves were in primary wound tract,four of which were lacerated and ruptured at different degrees.The light microscope showed pathological changes including severe hemorrhage and edema,leukocytic infiltration,neurotmesis,axonotmesis and light myelin coloration;while electron microscope showed severe degeneration of myelin sheath and neuraxon distortion.Six nerves(one in Group A and five in Group B)were in the concussion zone,with the distance between sciatic nerve and primary wound tract for(2.07±0.45)cm.Hyporrhea and hyperemia under perilemma and perineurium,partial nerve fiber disrupt and axonotmesis were observed by light microscope and partly myelin sheath delamination by electron microscope.Two nerves (one in Group A and another in Group B)were in the contusion zone,with moderate pathological changes.Conclusions The track of high velocity triangle fragments is unstable in the tissues.High disrupt rate,severe and wide extent lesion,early Wallerian degeneration are the main characteristics of direct injuries of swine's sciatic nerves.Indirect injuries can induce pathologic changes too,for which the lesion severity is related to the distance between nerves and primary wound tract.
