CAJ | 학술논문

目的观察爆炸冲击波致肢体周围大血管造成损伤的病理特点,为四肢战伤救治、预防并减少并发症提供理论依据. 方法将18只家兔采用随机数字表法分为三组,每组6只兔,均匀布放于距爆心1,2,3 m处,电启动引爆离地面60 cm高的液体炸药制作冲击伤动物模型.用美国PCB公司生产的压力传感器测定冲击波的物理参数,致伤后对兔股动脉血管进行大体形态、组织学及免疫组织化学观察. 结果股动脉血管内皮细胞剥脱;血管平滑肌细胞间隙增大呈疏松状;血管的弹力纤维有明显的断裂,屈曲变形;部分血管壁全层断裂或部分断裂,导致出血.Tunel染色、荧光显微镜下观察,在血管内皮层、中间平滑肌层、血管外膜中见大量的凋亡细胞.结论爆炸冲击波瞬时作用对肢体周围大血管损伤严重,在冲击伤救治中应引起足够的重视.
목적 관찰폭작충격파치지체주위대혈관조성손상적병리특점,위사지전상구치、예방병감소병발증제공이론의거. 방법 장18지가토채용수궤수자표법분위삼조,매조6지토,균균포방우거폭심1,2,3 m처,전계동인폭리지면60 cm고적액체작약제작충격상동물모형.용미국PCB공사생산적압력전감기측정충격파적물리삼수,치상후대토고동맥혈관진행대체형태、조직학급면역조직화학관찰. 결과 고동맥혈관내피세포박탈;혈관평활기세포간극증대정소송상;혈관적탄력섬유유명현적단렬,굴곡변형;부분혈관벽전층단렬혹부분단렬,도치출혈.Tunel염색、형광현미경하관찰,재혈관내피층、중간평활기층、혈관외막중견대량적조망세포.결론폭작충격파순시작용대지체주위대혈관손상엄중,재충격상구치중응인기족구적중시.
Objective To observe pathological features of peripheral vessel injury caused by ex-plosion shock wave so as to provide theoretical basis for emergency treatment, prevention and complication reduction of war extremity injuries. Methods A total of 18 rabbits were randomly divided into three groups (six rabbits in each group) and placed respectively at 1, 2 and 3 m away from the explosion cen-ter. The animal model with blast injury was made by using fluid dynamite that electrically exploded at 60 cm above the ground. The physical parameters of blast wave were recorded using pressure transducers (PCB, UAS). After explosion, the femoral arteries were examined grossly, histologically and immunohis-tochemically. Results The results showed that vascular endothelial cells were denudated, the spaces of contractile fiber cells increased and appeared puff, the vassular elastic fibers ruptured, flexed and de-formed visibly. Some parts of the vessel wall ruptured completely or partly, leading to bleeding. TUNEL staining and fluorescence microscope found large number of apoptotic cells in endothelium layer, smooth muscle layer and membrana adventitia layer of the blood vessels. Conclusion Explosion shock wave can result in severe large blood vessel injury, which should be paid much attention during treatment of ex-plosion shock injury.