便携式野战创伤性血气胸救治包的设计制作及应用研究

Development of portable first aid package for traumatic hemopneumothorax on battlefield

目的 :设计制作便携式野战创伤性血气胸救治包并验证其对创伤性血气胸的救治效果。方法 :自行设计并制备便携式野战创伤性血气胸救治包 (简称自制救治包 ) ,配备有胸腔闭式引流管 (穿刺针、固定气囊和内冲洗管三合一 )、折叠式引流袋及操作附件等。以犬为实验动物 ,随机分为对照组 (4只 )和实验组 (8只 )。以胸腔内注入血液 70 0 ml及气体 2 0 0 m l制作创伤性血气胸模型。对照组使用临床常规胸腔闭式引流装置 ,实验组采用自制救治包分别行胸腔闭式引流术 ,比较两组动物的手术时间、引流量、胸壁固定所承受拉力 ,并观察自制救治包引流管的冲洗效果及对肋间血管的止血效果。 结果 :自制救治包大小 2 6 0 mm× 170 m m× 5 0 mm、总质量 (315± 10 ) g,实验组手术时间为 (5 .5± 1.2 ) min,较对照组 [(12 .0± 2 .3) min]显著缩短 (P<0 .0 1) ;对照组术后 0 .5、1、2、4、6 h引流量分别为 (113± 12 )、(2 5 8± 2 2 )、(44 1± 2 8)、(5 72± 33)、(6 2 3± 5 2 ) ml,实验组分别为 (12 6± 17)、(2 4 2± 2 4 )、(46 2± 32 )、(5 90± 4 2 )、(6 32± 37) m l,两组间在术后各时间段均无显著性差异 (P>0 .0 5 ) ;对照组能承受 (5 .0± 0 .3) kg拉力 ,实验组能承受 (8.0± 0 .2 ) kg拉力 (P<0 .0 1) ;

Objective:To develop a first aid package for traumatic hemopneumothorax on battlefield and to validate its effectiveness. Methods: The portable first aid package, 26 cm×17 cm×5 cm in size, consisted of a closed drainage tube (thoracentesis needle,air pocket fixed inside and washing pipe),folded drainage bag and appendages for operation.Twelve adult dogs were randomly divided into 2 groups: control group(n=4) and experimental group(n=8). Blood and air were infused into thoracic cavity to produce traumatic hemopneumothorax model. The control group was treated with closed drainage of normal surgical instrument, while the experimental group was treated with the first aid package we designed. The operation time,the volume of drainage,the pulling force to fix the tube at chest wall, the flushing effect and hemostasis effect of the 2 groups were compared. Results: The operation time in experimental group was (5.5±1.2) min, which was significantly shorter than that in control group [(12.0±2.3) min, P<0.01].The drainage volume were (113±12),(258±22),(441±28),(572±33) and (623±52) ml respectively on 0.5,1,2,4,6 h after operation in control group, and were (126±17), (242± 24), (462±32),(590±42), and (632±37) ml in experimental group,with no significant difference between the 2 groups (P> 0.05). The pulling force of the tube was (5.0±0.3) kg in control group,and more than (8.0±0.2) kg in experimental group(P<0.01). The irrigation equipment of drainage tube may dribble liquid at maximal speed (700±20) ml/h in experimental group.The air pocket internal fixed had hemostasis effect when the infra-rib blood vessel were broken. Conclusion: The portable first aid package for traumatic hemopneumothorax has the same drainage effect as normal closed drainage instrument has, but it has small volume and good portability.