CAJ | 학술논문

目的分析研究海岛湿热环境下脊髓火器伤后6h内血液流变学的变化特点.方法 18头南方实验用猪按数字表法随机分成常温常湿火器伤组、高温高湿对照组及高温高湿火器伤组,每组6只.构建胸腰段脊髓火器伤动物模型,处理前及处理后0.5、1、2、4、6h分别抽血进行血液黏度、红细胞沉降率、红细胞聚集指数以及变形指数等血液流变学指标检测.结果高温高湿对照组和常温常湿火器伤组血浆黏度变化差异无统计学意义,但高温高湿火器伤组全血高、中、低切黏度在伤后各时间点与其他2组同一时间点相比差异均存在统计学意义(P ＜0.05或P＜0.01).3组在处理后血沉均明显高于干预前,但高温高湿火器伤组的血沉值升高尤其明显,6h时明显高于其他2组,差异有统计学意义(P＜0.05).3组处理后红细胞聚集指数和变性指数的变化趋势各不相同:常温火器伤组在处理后2个指数逐渐升高,高温高湿对照组在处理后先降低后逐渐恢复正常,高温高湿火器伤组处理后先升高,在伤后4～6h急剧降低且低于处理前水平,差异有统计学意义(P＜0.01).结论海岛高温高湿环境下脊髓火器伤早期血液流变学变化显著,其变化幅度和趋势与常温常湿火器伤和单纯高温高湿的环境影响均不同,应对这一特殊现象进一步研究,以采取相应的针对性救治措施.
목적 분석연구해도습열배경하척수화기상후6h내혈액류변학적변화특점.방법 18두남방실험용저안수자표법수궤분성상온상습화기상조、고온고습대조조급고온고습화기상조,매조6지.구건흉요단척수화기상동물모형,처리전급처리후0.5、1、2、4、6h분별추혈진행혈액점도、홍세포침강솔、홍세포취집지수이급변형지수등혈액류변학지표검측.결과 고온고습대조조화상온상습화기상조혈장점도변화차이무통계학의의,단고온고습화기상조전혈고、중、저절점도재상후각시간점여기타2조동일시간점상비차이균존재통계학의의(P ＜0.05혹P＜0.01).3조재처리후혈침균명현고우간예전,단고온고습화기상조적혈침치승고우기명현,6h시명현고우기타2조,차이유통계학의의(P＜0.05).3조처리후홍세포취집지수화변성지수적변화추세각불상동:상온화기상조재처리후2개지수축점승고,고온고습대조조재처리후선강저후축점회복정상,고온고습화기상조처리후선승고,재상후4～6h급극강저차저우처리전수평,차이유통계학의의(P＜0.01).결론 해도고온고습배경하척수화기상조기혈액류변학변화현저,기변화폭도화추세여상온상습화기상화단순고온고습적배경영향균불동,응대저일특수현상진일보연구,이채취상응적침대성구치조시.
Objective To study and analyze changes in hemorheology 6 hours after spinal cord firearm injury in the environment of high temperature and humidity.Methods Eighteen healthy experimental hogs were randomly divided into the normal temperature and humidity firearm injury group,the high temperature and humidity control group and the high temperature and humidity firearm injury group,each consisting of 6 animals.An animal model of firearm spinal cord injury in the thoracic and lumbar section was developed with gunshots.Blood samples were taken to measure such hemorheological indices as blood viscosity,erythrocyte sedimentation,hemagglutination,erythrodegeneration both before intervention and at hours 0.5,1,2,4 and 6 after intervention.Results No statistical significance could be noted in changes of hemorheology for both the high temperature and humidity control group and the normal temperature and humidity firearm injury group,following injury.However,for the high temperature and humidity firearm injury group,statistical differences could obviously be noticed in high-shear,medium-shear and low-shear viscosity in whole blood at various time points after injury,as compared with the data detected at various time points in the other two groups (P ＜ 0.05 or P ＜ 0.01).Blood sedimentation after intervention was significantly higher than that before intervention.The blood sedimentation level of the high temperature and humidity firearm injury group elevated most significantly,and at hour 6 it was obviously higher than those of the two other groups,with statistical significance.Trend in the changes of red blood cell aggregation and denaturation differed from one another for the 3 groups after intervention.Namely,the above two indices for the normal temperature and humidity firearm injury group increased gradually after intervention,but for the high temperature and humidity control group,the indices soon returned to normal level after they reduced temporarily.As for the high temperature and humidity firearm injury group,elevation of the said indices could be noticed first,then,they dropped sharply at hours 4-6,which were lower than those before intervention,with statistical differences.Conclusions Significant changes could be noted in hemorheology at initial stage of spinal cord firearm injury at high temperature and humidity environment in islands,with the amplitude and trend being obviously different from those of the conventional firearm injury and the simple high temperature and humidity environment.Aimed at this unique problem,further research should be made,so as to take corresponding measures for the care of casualties in such environment.