腹部多发脏器伤模型的建立及评价

Reproduction and evaluation of abdominal multiple organ trauma model

目的在小型猪上建立可重复、可控制的腹部多发脏器伤实验模型。方法选取中国实验用小型猪15只,动物实验方法符合动物伦理学要求。使用自行研制的爆炸装置,分别将0.3、0.2、0.2g黑火药制成的电子鞭炮置于猪肝左外叶、脾下极和胰体尾部的表面,将猪的肝、脾及胰腺炸伤。记录猪行剖腹游离手术时间、失血量、肝脏和脾脏炸伤的最长径及面积、胰腺炸伤的长度及程度,观察术中平均动脉压(MAP)的变化,并给予损伤严重程度评分(ISS)。结果肝脏毁损面积为9.2±0.3cm2,毁损最长径为5.4±0.2cm;脾脏毁损面积为5.2±0.1cm2,毁损最长径为5.6±0.2cm;胰腺毁损长度6.3±0.2cm。MAP下降一半的时间为8.8±0.5min,MAP下降一半时出血量为704.7±14.6ml,致伤后死亡时间(前5只)为25.4±1.8min,ISS为28.0±0.8。成功建立小型猪腹部多发脏器伤模型。结论利用自制的致伤引爆装置及电子鞭炮制备腹部多发脏器伤模型具有可重复性、可控性及稳定性良好等特点,可用于交通伤和野战外伤等救治的实验研究。

Objective To establish a reproducible and controllable experimental swine model of abdominal multiple organ trauma. Method Fifteen pigs were included in the present study, and the method adopted conformed to the animal ethics. With the self-made explosive device, the electric firecrackers consisting of 0. 3g, 0. 2g and 0. 2g black powder were put respectively onto the surface of left lateral lobe of liver, lower pole of spleen and tail of pancreas to produce injuries by explosion. The operation time of exploratory laparotomy and isolation of the organs, blood loss, the maximum diameter and area of injury to the liver and spleen due to explosion, the length and extent of the pancreas that was injured in explosion, as well as the changes in mean arterial pressure （MAP） during the operation were detected and recorded. Finally, the injury severity score （IS-S） was calculated. Results The damaged liver area was 9. 24-0. 3cm^2 , the maximum diameter of damaged liver was 5. 4±0. 2cm, the damaged spleen area was 5. 2±0.1cm^2 , the maximum diameter of damaged spleen was 5. 6±0. 2cm, the damaged pancreas length was 6. 3±0. 2cm, the time for MAPs to lower by half was 8. 8±0. 5min, the blood loss for depression of MAP by half was 704. 7±14. 6ml, the time from injury to death in the first 5 pigs was 25.4±1. 8min, ISS was 28. 0 ±0. 8. The experimental swine model of abdominal multiple organ trauma was reproduced successfully. Conclusions By using the self- made explosion device and electric firecrackers, the abdominal multiple organ trauma model is reproducible, controllable and stable. It can be generally used in the research of war trauma and traffic accident trauma.