以动物模型为基础的腹部战伤损伤控制手术模拟训练

Animal Model-based Simulation Training for Damage Control Operation of Combat Abdominal Injury

目的为提高基层军医的腹部战伤损伤控制手术能力,采用枪弹伤动物模型进行模拟训练。方法以自制研发的实验动物致伤平台为基础,将家猪固定于致伤仪器上,瞄准指定部位,用空气冲击波将直径为4.98 mm的钢珠激发,制成"非均一性"腹部枪弹伤动物模型,根据伤情完成适宜的损伤控制手术。在8个基层单位的卫生机构中,以每5人为一手术组分组进行模拟训练,并按照腹部损伤控制手术评分标准,在训练前和训练后进行考核评分。结果根据需要可构建肝脏、脾脏、血管、胃肠道及系膜损伤等枪弹伤动物模型,非常贴近战时实际损伤情况,适用于损伤控制手术训练,并在此模型下开展腹部损伤控制手术模拟训练,训后成绩提高了24.60%。结论本研究建立的动物模型及模拟训练流程有利于提高基层军医腹部损伤控制手术能力。

Objective To improve the damage control operation ability of primary-level military doctors,bullet wound animal model was established to training the damage control operations for combat abdominal injury.Methods Based on a home-made experimental animal injury platform,porcine were fixed on the injury instrument,targeted at the abdomen,and injured by a steel ball with a diameter of 4.98 mm propelling by highly compressed air shock.Then the trainees were asked to complete the proper damage control procedures according to the injury state.Five personnel were selected from 8 basic military health care units respectively to form a operation team and accept damage control operation training.They were assessed according to the test standard before and after the training.Results According to actual needs,animals models of gunshot wound of liver,spleen,blood vessels,gastrointestinal tract,and mesangial injuries could be successfully constructed,which were very close to the actual injury situation in war and suitable for damage control operation training.Then abdominal damage control operation simulation was carried out with this model,and it was revealed that the training could improve the performance by 24.60%.Conclusion The animal model and simulation training process established in the current study are helpful to improve combat abdominal injuries damage control operation ability of doctors from basic military health care units.