低温环境下放射性与火器复合伤后细菌学改变的研究

Bacteriological study of firearm combined radiation wound in hypothermia environment

目的观察低温环境下放射性与火器复合伤(下称放火器复合伤)后伤道及血液细菌学变化特点,为其临床救治提供理论依据。方法以30只新西兰大白兔制备低温放火器复合伤动物模型,分别于致伤后0、4、8、16、24、48 h进行实验动物体温变化动态观察,伤道及血液中的细菌定性培养及菌群种类分析。结果低温放火器复合伤动物体温伤后明显升高,伤后4 h平均体温达(39.47±0.39)℃,体温变化趋势非常显著。伤后4 h,伤道局部分泌物中细菌为表面菌群,伤后8 h检测到肠道菌群。血液中出现细菌的时间为伤后8 h,既有表面菌群,又有肠道菌群。结论低温放火器复合伤后体温升高明显,细菌感染较严重,细菌入血时间早,肠道细菌容易入血,处理应尽早清创,早期合理使用广谱抗生素。

Objective To investigate the characteristic of bacteriological change of wound tract and blood of firearm combined radiation wound in hypothermia environment,and to provide the reference data for clinical remedy.Methods The animal model of firearm combined radiation wound was established in hind limbs of thirty rabbits in hypothermia environment.At the time points of 0,4,8,16,24,48 h after wounded,the body temperature of animal was observed dynamically,and bacterial quantitative culture and flora analysis were performed.Results Body temperature was elevated obviously in firearm combined radiation wound in hypothermia environment,which was as high as 39.47±0.39℃ after 4 h wounded.The difference was very significant.The surface bacteria were detected in the wound tracts after 4 h wounded,while the intestinal floras were detected after 8 h wounded.The bacterial invasion into the blood occurred after 8 h wounded.There were both surface bacteria and intestinal flora in the culture.Conclusion In firearm combined radiation wound in hypothermia environment,there are obvious elevation of the body temperature,serious bacterium infection attribute to earlier and easily bacterial invasion into the blood,especially the intestinal flora.So the earlier and complete debridement of the wound tracts and the rational application of broad-spectrum antibiotics should be emphasized after wound.