CAJ | 학술논문

目的研究放烧复合伤的实验治疗及其病理学基础. 方法昆明种小鼠和Wistar 大鼠由60Co源γ射线照射致放射损伤,5 kW 溴钨灯热辐射致烧伤,两者合并致复合伤.结果心肌功能损害在早期休克的发生发展中有重要作用.受照射后输入照射血(体外照射 20 Gy)或贮存血(4℃,7天)促进异体骨髓移植成功.肠淋巴组织IL-4 mRNA表达受抑是肠黏膜免疫降低的分子基础,IL-4能有效降低肠源性感染的发生.从烧伤焦痂中首次分离到一种新的脂质成分,我们初步揭示其毒性效应.放射损伤抑制排异反应,从而显著提高早期切痂后所植异体皮的活存率;而单纯烧伤组所植异体皮于10 天前全部发生排异.综合治疗后极重度放烧复合伤(不治疗于伤后3-7天内全部死亡)30天存活率为92%,100天存活率为67%.结论放射损伤合并烧伤后,发病机制十分复杂,治疗甚为困难.经针对发病关键环节的综合治疗,取得治疗的成功.
목적연구방소복합상적실험치료급기병이학기출. 방법곤명충소서화Wistar 대서유60Co원γ사선조사치방사손상,5 kW 추오등열복사치소상,량자합병치복합상.결과심기공능손해재조기휴극적발생발전중유중요작용.수조사후수입조사혈(체외조사 20 Gy)혹저존혈(4℃,7천)촉진이체골수이식성공.장림파조직IL-4 mRNA표체수억시장점막면역강저적분자기출,IL-4능유효강저장원성감염적발생.종소상초가중수차분리도일충신적지질성분,아문초보게시기독성효응.방사손상억제배이반응,종이현저제고조기절가후소식이체피적활존솔;이단순소상조소식이체피우10 천전전부발생배이.종합치료후겁중도방소복합상(불치료우상후3-7천내전부사망)30천존활솔위92%,100천존활솔위67%.결론방사손상합병소상후,발병궤제십분복잡,치료심위곤난.경침대발병관건배절적종합치료,취득치료적성공.
Objective To investigate therapeutics for and the pathological basis of combined radiation and bur*$ n injuries.Methods Combined radiation and bur*$ n injuries on mice and rats were inflicted by γ ray irradiation from a 60 Co source and thermal radiation from a 5 kW bromotungsten lamp.Results The dysfunction of myocardium played an important role in the development of early stage shock. Transfusion of irradiated (in vitro, 20 Gy) or stored (4℃, 7 days) blood after irradiation was done to promote the success of allo-transplantation of bone marrow. Decrease of IL-4 mRNA expression was the molecular basis of depression of intestinal mucosa immune and intervention of IL-4 showed an antagonistic effect on enterogenic infection. A new lipid component extracted from bur*$ n eschar was documented for the first time and its toxic effects were elucidated. The survival rate of alloskin grafts after removal of bur*$ n eschar from the recipient animals was obviously increased in combined injury due to reduction of immune rejection activity by the radiation effect. In contrast, in animal models with simple bur*$ n, the alloskin grafts were all rejected within ten days after the procedure. A successful therapeutic result (survival rate: 92% for 30 days and 67% for 100 days) was obtained by comprehensive management of treated animals, while the untreated control animals all died within 3-7 days after injury.Conclusion The pathogenesis of injury caused by simultaneous radiation and bur*$ n is extremely complicated and the treatment is very difficult. A comprehensive management program consisting of several therapeutic measures aimed at key links of the pathogenesis may achieve significantly improved results.