CAJ | 학술논문

目的建立一种简便、特异的大鼠单纯双肺挫伤模型,并确定最大亚致死损伤能量.方法以自由落体砝码产生能量,通过特制的心前区保护平板将能量传导至大鼠双侧后胸壁.根据不同能量分为4组:2.1,2.4,2.7,3.0J组.伤后4h,通过动脉血气分析、三维计算机成像(3DCT)测定肺挫伤占双肺容积百分比评价肺挫伤后肺损伤程度,并行肺、心肌病理学检查确诊肺挫伤和排除心肌挫伤.结果损伤能量3.0J组大鼠死亡率高达33％,2.4J组死亡率11％;2.7J组PaO2明显低于2.4J组(P＜0.01),肺挫伤容积百分比明显高于2.4J组(P＜0.01);各组PaO2与3DCT肺挫伤容积百分比均呈负相关(R2=0.762).肺活检可见出血、肺不张及中性粒细胞浸润.心肌活检未见明显肌纤维断裂等变化.结论本研究方法可复制满意的单纯双肺挫伤模型,2.7J可视为本模型的最大亚致死损伤能量.
목적 건립일충간편、특이적대서단순쌍폐좌상모형,병학정최대아치사손상능량.방법 이자유락체겁마산생능량,통과특제적심전구보호평판장능량전도지대서쌍측후흉벽.근거불동능량분위4조:2.1,2.4,2.7,3.0J조.상후4h,통과동맥혈기분석、삼유계산궤성상(3DCT)측정폐좌상점쌍폐용적백분비평개폐좌상후폐손상정도,병행폐、심기병이학검사학진폐좌상화배제심기좌상.결과 손상능량3.0J조대서사망솔고체33％,2.4J조사망솔11％;2.7J조PaO2명현저우2.4J조(P＜0.01),폐좌상용적백분비명현고우2.4J조(P＜0.01);각조PaO2여3DCT폐좌상용적백분비균정부상관(R2=0.762).폐활검가견출혈、폐불장급중성립세포침윤.심기활검미견명현기섬유단렬등변화.결론 본연구방법가복제만의적단순쌍폐좌상모형,2.7J가시위본모형적최대아치사손상능량.
Objective To create an easy and specific rat model of isolated bilateral pulmonary contusion and determine the maximal sublethal injury energy.Methods Injury energy was produced by free falling weights and passed through a designed precordial shield to rats' bilateral posterolateral chest wall.The rats were divided into 2.1 J,2.4 J,2.7 J and 3.0 J groups,according to the volume of injury energy.Percentage of lung contusion volume in bilateral lung was measured by blood gas analysis and three dimensional CT (3DCT) at four hours post-injury to assess lung injury severity after contusion.Pathological examination of heart and lung tissue was performed to confirm pulmonary contusion and rule out myocardial contusion.Results Death rate in 3.0 J and 2.4 J groups was 33％ and 11％,respectively.PaO2 in 2.7 J group was significantly lower than that in 2.4 J group (P ＜ 0.01),but pulmonary contusion percentage in 2.7 J group was significantly higher than that in 2.4 J group (P ＜0.01).All groups showed negative correlation between PaO2 and pulmonary contusion percentage measured by 3DCT (R2 =0.762).Hemorrhage,atelectasis and neutrophil infiltration were documented in lung biopsy.No evidence of myofiber break was recorded in heart biopsy.Conclusion This method can duplicate satisfactory models of isolated bilateral pulmonary contusion and 2.7 J can be regarded as the maximal sublethral injury energy.