中华损伤与修复杂志（电子版）
中華損傷與脩複雜誌（電子版）
중화손상여수복잡지（전자판）
Chinese Journal of Injury Repair and Wound Healing
2015年
2期
152-159
,共8页
朱富军%詹球%童亚林%梁静%阳齐琼%刘亮%李泳%夏樱花%吕璐%莫永亮%陈云鹏%朱金红%冯小艳%龚震宇%辛海明%邹篪
硃富軍%詹毬%童亞林%樑靜%暘齊瓊%劉亮%李泳%夏櫻花%呂璐%莫永亮%陳雲鵬%硃金紅%馮小豔%龔震宇%辛海明%鄒篪
주부군%첨구%동아림%량정%양제경%류량%리영%하앵화%려로%막영량%진운붕%주금홍%풍소염%공진우%신해명%추지
蒸汽%烧伤,吸入性%模型,动物
蒸汽%燒傷,吸入性%模型,動物
증기%소상,흡입성%모형,동물
Steam%Burns,inhalation%Models,animal
目的：建立严重、危重与极危重3个层级重度蒸汽吸入性损伤兔模型。方法随机将136只新西兰大白兔分为假伤组（n ＝34）与致伤组（n ＝102）。致伤组按蒸汽吸入致伤时间分为0．25、0．50、1．00 s 组（均 n ＝34），0．25、0．50、1．00 s 组兔用自动控时调压烫伤仪[11-12]控制蒸汽压力0．02 MPa／cm2、温度105℃条件下通过气管切开处分别致伤，假伤组兔除不予吸入蒸汽致伤外其它处理同致伤组。0．25、0．50、1．00 s 组与假伤组于伤后1、4、12、24 h 各取兔6只检测或观察动脉血氧分压（PaO2）与二氧化碳分压（PaCO2）、肺组织病理、肺组织含水率变化，各组另取10只兔观察伤后6、12、24 h 死亡率。结果1．00 s 组伤后1 h 即出现明显的肺充血水肿和出血、缺氧以及炎症细胞浸润状况并逐渐加重，伤后6 h 兔死亡率达100％。0．50 s 组伤后1 h 也出现肺充血水肿和出血、缺氧，至伤后4 h 加重并出现炎症细胞浸润，伤后1、4 h 的 PaO2较1．00 s 组高，差异有统计学意义（P ＜0．05），0．50 s 组兔伤后12、24 h 死亡率分别为25％、75％。0．25 s 组在伤后4 h 出现肺充血水肿、缺氧，伤后12 h 肺充血水肿加重并出现出血、炎症细胞浸润，伤后4、12、24 h PaO2均小于60 mmHg （1 mmHg ＝0．133 kPa），较0．50 s 组同时相点高，差异有统计学意义（P ＜0．05），较假伤组同时相点低，差异均有显著性统计学意义（P ＜0．01），0．25 s 组伤后24 h 兔死亡率为25％。结论在蒸汽压力为0．02 MPa／cm2，温度105℃条件下，致伤时间1．00、0．50、0．25 s 可分别造成兔极危重、危重和严重吸入性损伤。
目的：建立嚴重、危重與極危重3箇層級重度蒸汽吸入性損傷兔模型。方法隨機將136隻新西蘭大白兔分為假傷組（n ＝34）與緻傷組（n ＝102）。緻傷組按蒸汽吸入緻傷時間分為0．25、0．50、1．00 s 組（均 n ＝34），0．25、0．50、1．00 s 組兔用自動控時調壓燙傷儀[11-12]控製蒸汽壓力0．02 MPa／cm2、溫度105℃條件下通過氣管切開處分彆緻傷，假傷組兔除不予吸入蒸汽緻傷外其它處理同緻傷組。0．25、0．50、1．00 s 組與假傷組于傷後1、4、12、24 h 各取兔6隻檢測或觀察動脈血氧分壓（PaO2）與二氧化碳分壓（PaCO2）、肺組織病理、肺組織含水率變化，各組另取10隻兔觀察傷後6、12、24 h 死亡率。結果1．00 s 組傷後1 h 即齣現明顯的肺充血水腫和齣血、缺氧以及炎癥細胞浸潤狀況併逐漸加重，傷後6 h 兔死亡率達100％。0．50 s 組傷後1 h 也齣現肺充血水腫和齣血、缺氧，至傷後4 h 加重併齣現炎癥細胞浸潤，傷後1、4 h 的 PaO2較1．00 s 組高，差異有統計學意義（P ＜0．05），0．50 s 組兔傷後12、24 h 死亡率分彆為25％、75％。0．25 s 組在傷後4 h 齣現肺充血水腫、缺氧，傷後12 h 肺充血水腫加重併齣現齣血、炎癥細胞浸潤，傷後4、12、24 h PaO2均小于60 mmHg （1 mmHg ＝0．133 kPa），較0．50 s 組同時相點高，差異有統計學意義（P ＜0．05），較假傷組同時相點低，差異均有顯著性統計學意義（P ＜0．01），0．25 s 組傷後24 h 兔死亡率為25％。結論在蒸汽壓力為0．02 MPa／cm2，溫度105℃條件下，緻傷時間1．00、0．50、0．25 s 可分彆造成兔極危重、危重和嚴重吸入性損傷。
목적：건립엄중、위중여겁위중3개층급중도증기흡입성손상토모형。방법수궤장136지신서란대백토분위가상조（n ＝34）여치상조（n ＝102）。치상조안증기흡입치상시간분위0．25、0．50、1．00 s 조（균 n ＝34），0．25、0．50、1．00 s 조토용자동공시조압탕상의[11-12]공제증기압력0．02 MPa／cm2、온도105℃조건하통과기관절개처분별치상，가상조토제불여흡입증기치상외기타처리동치상조。0．25、0．50、1．00 s 조여가상조우상후1、4、12、24 h 각취토6지검측혹관찰동맥혈양분압（PaO2）여이양화탄분압（PaCO2）、폐조직병리、폐조직함수솔변화，각조령취10지토관찰상후6、12、24 h 사망솔。결과1．00 s 조상후1 h 즉출현명현적폐충혈수종화출혈、결양이급염증세포침윤상황병축점가중，상후6 h 토사망솔체100％。0．50 s 조상후1 h 야출현폐충혈수종화출혈、결양，지상후4 h 가중병출현염증세포침윤，상후1、4 h 적 PaO2교1．00 s 조고，차이유통계학의의（P ＜0．05），0．50 s 조토상후12、24 h 사망솔분별위25％、75％。0．25 s 조재상후4 h 출현폐충혈수종、결양，상후12 h 폐충혈수종가중병출현출혈、염증세포침윤，상후4、12、24 h PaO2균소우60 mmHg （1 mmHg ＝0．133 kPa），교0．50 s 조동시상점고，차이유통계학의의（P ＜0．05），교가상조동시상점저，차이균유현저성통계학의의（P ＜0．01），0．25 s 조상후24 h 토사망솔위25％。결론재증기압력위0．02 MPa／cm2，온도105℃조건하，치상시간1．00、0．50、0．25 s 가분별조성토겁위중、위중화엄중흡입성손상。
Objective To establish serious,critical and extra-critical model of severe inhalation injury induced by steam in rabbits.Methods One hundred and thirty six New Zealand white rabbits were randomly divided into the injury groups with 1 02 rabbits and the sham group with 34 rabbits.According to the injury time the injury groups were randomly divided into 3 groups and each group included 34 rabbits and those groups were respectively named the group of 0.25 s,0.50 s,1 .00 s.After placed a 5-mm inside diameter tracheal tube,animals in the injury groups were vulnerated by steam that came from an “automatic control time and pressure scald instrument”made at our lab which ensured the steam pressure 0.02 Mp /cm2 and temperature 1 05 ℃.In the injury groups the injury time was respectively 0.25 s,0.50 s,1 .00 s. Except inhalation injury induced by steam,the same treatment was given to the sham group with 34 animals as the injury groups.Throughout the experiment,We measured PaO2 ,PaCO2 of arterial blood sample using an automatic blood gas system in each group with 6 rabbits at each post injury time point (1 h,4 h,1 2 h, 24 h).we also examined the lung histopathology,the lung dry/wet weight ratio in each group with 6 rabbits at each post injury time point (1 h,4 h,1 2 h,24 h).We recorded the mortality rate in each group with additional 1 0 rabbits at various post injury time point (6 h,1 2 h,24 h).Results At 1 h of post injury the group of 1 .00 s appeared the changes that included significant pulmonary congestion,edema ,bleeding, hypoxia and inflammatory cells infiltration.The above changes were gradually aggravated with time and the mortality of rabbits at 6 h of post injury was 1 00%.At 1 h of post injury the group of 0.50 s also appeared the changes that included pulmonary congestion,edema,bleeding,hypoxia.The above changes were gradually aggravated at 4 h of post injury and inflammatory cells infiltrated into the lung tissue.PaO2 in the group of 0.50 s was higher than the group of 1 .00 s at 1 h,4 h of post injury,which indicated a statistical significance (P <0.05).The mortality of rabbits of the group of 0.50 s at 1 2 h,24 h of post injury was 25%,75%.In the group of 0.25 s,pulmonary congestion,edema and hypoxia were observed at 4 h of post injury.At 1 2 h of post injury ,pulmonary congestion and edema combined with pulmonary bleeding,hypoxia and inflammatory cells infiltration were gradually aggravated in the group of 0.25 s.PaO2 in the group of 0.25 s decreased to a level of less than 60 mmHg at 4 h,1 2 h,24 h of postinjury.PaO2 in the group of 0.25 s was higher than the group of 0.50 s at the same time-point of post injury,which indicated a statistical significance (P <0.05).PaO2 in the group of 0.25 s was lower than the sham group at the same time-point of post injury (P <0.01 ).The mortality of rabbits of the group of 0.25 s at 24 h of postinjury was 25%. Conclusion By inhaling the steam of 0.25 s,0.50 s,1 .00 s that the steam pressure was 0.02 Mp /cm2 and temperature was 1 05 ℃,the stable serious,critical and extra-critical model of inhalation injury induced by steam can be reproduced in rabbits.
