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水下冲击伤处理原则的初步探讨 被引量:6

Treatment of underwater blast injury in dogs
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摘要 目的探讨犬水下冲击伤的处理原则。方法成年杂种犬61只,200、500、1 000g TNT水下爆炸致水下冲击伤,观察伤后6小时内动物存活情况、临床症状体征、动脉血气分析和形态学改变。结果本组动物存活38只,死亡23只,死亡率37.7%。形态学改变主要为不同程度的肺出血和肺水肿,胃肠道浆膜和黏膜下出血,高冲量时可引起胃肠道穿孔和肝脾破裂。轻度和中度伤动物除一过性体温降低外,临床未见明显改变,而重度以上损伤的动物可见呼吸加快、体温下降或不回升、心动过缓、口鼻流血性泡沫样液体、PaO2下降、PaCO2升高等,以极重度伤更为明显。结论保持呼吸道通畅,快速复温,容量复苏,维护心肺功能,防治呼吸功能不全、空气栓塞、D IC等并发症是水下冲击伤救治的原则。 Objective To explore the treatment principles of underwater blast injury in dogs. Methods Sixty-one adult dogs were injured by explosion of 200,500 and 1000g TNT respectively underwater. The survival rate, clinical symptoms and physical signs, arterial blood gas analysis, and morphological changes were observed or monitored 6 hours after injury. Results Thirty-eight dogs survived and 23 dogs died after injury,the mortality rate was 37.7 %. The predominant morphological changes were the bleeding and edema of lung of different degrees, submucosal and subserosal bleeding in the injured gastrointestinal tract. The perforation of gastrointestinal tract and/or the ruptures of liver or spleen were found in the animals exposed to high dose blast wave. No significant clinical changes,except the transient decrease of body temperature,was observed in the animals suffering from mild or moderate injuries. Tachypnea, consistent decrease of body temperature, bradycardia, frothy bloody effluent from mouth or nose,decrease of PaO2,increase of PaCO2 were found in the more severely injured animals. Conclusion The study suggested that the primary principles of treatment of underwater blast injury includes keeping air way unobstructed, fast rewarming and volume resuscitation, maintaining heart and lung function, preventing respiratory insufficiency, aeroembolism, DIC and other complication.
出处 《创伤外科杂志》 2006年第3期234-237,共4页 Journal of Traumatic Surgery
基金 全军医学科研"十五"指令性课题(01L067)
关键词 冲击伤 水下 救治 blast injury underwater treatment dog
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