枪弹所致血流强扰动后血液流变学变化及其对伤情转归的影响

Hemorheologic Change after Strong Blood Flow Disturbance Caused by Gunshot and Its Influence on the Prognosis of the Wounded Animals

采用Ｍ１９３５５６ｍｍ枪弹对犬双后肢致伤、双侧股动静脉结扎后致伤及单纯放血致休克三组实验模型，重点观察了血液流变学发生的一系变化特点，分析探讨了其在伤情转归中的作用。结果表明：高速投射物所产生的血流强烈扰动，可导致全血粘度急剧增高、红细胞聚集增加及血液浓缩等流变学变化，可能与血流强烈扰动造成血管内皮细胞损伤以及血液中细胞成分的破坏有关。上述变化可导致微循环的改变和物质传输的紊乱，进而为严重并发症的发生发展提供病理生理基础。

Three types of exprerimental models were used in this study:① Both thighs of dogs were wounded by 5.56mm bullet. ②Femoral artery and vein were tied at the time of wounding. ③Shock caused by simply bleeding the dogs' femoral arteries. We observed the characteristics of change hemorheology and analyzed its effects on the wounded dogs. The results showed that strong blood flow disturbances always brought about hemorheologic changes such as rapidly increased blood viscosity and red cell's aggregation index and the simultaneous phenomenon of blood concentration. These may be related to extensive endothelium injury and destruction of a number of blood cells caused by disturbance wave. The above change may give rise to abnormality of microcirculation and disturbance of matter transmisson; in that sense, it may provide the physiopathologic basis for the occurrence and development of the complication.