高温高湿环境下颅脑火器伤治疗的实验研究

Experimental study on treating craniocerebral firearm injuries in hot and humid environment

目的探讨在高温高湿环境下颅脑火器伤的治疗效果,提出有效的治疗方法。方法选取60只成年杂种犬,制作出高温高湿环境下[Ta(38．0±0．5)℃,RH80%一85%]犬颅脑火器伤的动物模型,随机分成两组,对照组30只采用常规治疗,治疗组30只在常规治疗的基础上加用乌拉地尔、B-七叶皂甙钠、亚低温等综合治疗法。对两组动物进行经颅多普勒超声、血液流变学、颅内压监测和对疗效进行比较。结果治疗组脑血管痉挛发生率低,TCD显示血流速度接近正常；血液粘滞度与对照组比较降低(P＜0．01)。在综合治疗3 h后颅内压明显下降。治疗组7 d内死亡率明显降低。结论乌拉地尔具有中枢性降温作用,B．七叶皂甙钠可减缓脑水肿的进程,亚低温可降低颅内压和改善脑组织氧代谢,综合治疗对于高温高湿环境下犬颅脑火器伤具有显著疗效。

Objective To investigate the efficacy of different treatments on craniocerebral firearm injuries （CFI） in hot and humid environment （HHE） and to put forward a better management proposal. Methods 60 mongrel dogs were made into models of （CMI） in HHE [ Ta （ 38.0 ± 0.5 ） ℃, RH80% - 85% ] The dogs were randomly divided into two groups. 30 dogs were given routine treatment （ control group） and the other 30 dogs were given urapidil plus β-aescine hypothermia treatment （synthetical treatment group）. The TCD, hemorheology, ICP and treatment efficacy of the two groups were compared. Results Brain vasospasm incidence rate was low in the treatment group, and TCD indicated that blood flow speed approached normal. Blood viscosity was significantly diminished in the synthetical treatment group, compared with the control group （P〈0. 01 ）. The ICP significantly decreased after 3 hours of synthetical treatment, mortality in 7 days was significantly reduced in the treatment group. Conclusions Urapidil is effective in decreasing the central temperature in of CMI in HHE. β-aescine sodium can diminish viscosity and slow down brain edema progress. Moderate hypothermia treatment can obviously reduce ICP and improve brain tissue oxygen metabolism to lower the mortality rate of CMI in HHE.