经海水浸泡重型开放性颅脑创伤早期清创范围的实验研究

Experimental study on different scale of early debridement for severe open craniocerebral injury with seawater immersion

目的探讨经海水浸泡重型开放性颅脑创伤早期不同清创方法对神经细胞形态和动物存活时间的影响。方法采用自由落体直接打击法制备重型开放性颅脑创伤兔模型,经海水浸泡后30 min分别施行大清创和小清创,观察两组动物清创后24 h脑组织形态和神经细胞肿胀程度,以及清创后1周存活时间。结果大清创组动物创缘神经细胞肿胀较轻,排列整齐,空泡化轻微;小清创组动物创缘神经细胞肿胀严重,空泡化明显。两组动物平均存活时间分别为(162.00±11.11)h和(141.00±20.03)h,组间差异具有统计学意义(t=3.667,P=0.001)。结论经海水浸泡重型开放性颅脑创伤早期施行大清创,可减轻神经细胞肿胀、坏死并显著延长生存时间。

Objective To investigate mo-rphological change of brain cells and survival time of experimental animals applying different early debridement methods for severe open eraniocerebral injury with seawater immersion. Methods Severe open craniocerebral injury rabbit models were established by direct pounding with freely falling body. The experimental animals were immersed in seawater for 30 min and randomly divided into 2 groups： large scale debridement group （group A, n= 16） and small scale debridement group （group B, n = 16）. Morphological change of brain cells and neurocyte swelling at wound edge were examined under light microscope and electron microscope 24 h after debridement, and survival time of experimental animals was observed one week after debridement. Results Neurocyte swelling and vacuolization of wound edge in group A were slight in comparison with those in group B. The organella in group A were nearly normal, but those in group B were degenerated or necrotic. Average survival time in group A was （162.00 ± 11.11） h, and in group B was （141.00±20.03）h. The difference between 2 groups was significant （t = 3.667, P=0.001）. Conclusion Early large scale debridement can alleviate neurocyte swelling and obviously prolong the survival time of severe open craniocerebral injury with seawater immersion.