一种新型严重肝外伤模型的建立及评价

Establishment and evaluation of a new severe hepatic trauma model

目的建立一种严重肝外伤动物模型并对其进行评价。方法选取中国实验用小型猪11只,使用自行研制的MT-1型体内爆炸致伤装置,以0.4g黑火药制成标准化爆炸物,开腹并将爆炸物置于小型猪拟致伤肝叶表面,周围脏器以绵质医用纱布隔离保护,引爆致伤。测定肝脏毁损面积(S)、失血量(V)、平均动脉压(MAP),用以评价模型动物的局部伤情及伤后血流动力学的变化情况。结果肝脏毁损面积为12.19±2.28cm2。MAP于伤后早期(2～7min)呈线性下降,下降速率为6.58±2.30mmHg/min,下降至伤前一半水平的时间为7.22±0.37min。MAP下降至伤前一半水平时的失血量为466±79ml。前3只实验动物未行救治,致伤至死亡时间为23～31min。结论所制备的严重肝外伤小型猪模型伤情符合人类肝外伤AASTⅣ级标准,且具有重复性好、可控性强等优点,可用于野战外伤及交通伤的救治研究。

Objective To establish and evaluate a severe hepatic trauma model.Methods Eleven Chinese miniature swine for experiments were used in the current study.Using the self-made explosive-actuated device（MT-1）,the explosive substance was prepared from 0.4 g black gunpowder and was placed on the diaphragmatic surface of the target hepatic lobe after the miniature swine had received celiotomy.Protective isolation for adjacent structure was then conducted,and then ＂fire＂.The parenchyma area（S） was destroyed,and the mean arterial pressure（MAP） and blood loss（V） were measured to evaluate the local injury of the model animals and the changes of hemodynamics after being injured.Results The area（S） of the destroyed parenchyma was 12.19±2.28 cm2.MAP presents the linear decline from 2 min to 7 min in the early stage post injury,with a decreasing rate of 6.58±2.30 mmHg/min and a period of 7.22±0.37 min when dropped to half.Blood loss was 466±79 ml when MAP drops to half of the level before injury.Treatment was not initiated for the first three animals and the time to death was between 23 min and 31 min.Conclusions The prepared model of severe hepatic trauma miniature swine corresponds with grade IV（AAST） in human.The current model can be used to study war and traffic accident traumas due to its good repeatability and strong controllability.