颌面部爆炸伤软组织损伤特点的实验研究

Study on the charateristics of maxillofacialSoft tissue in blast injury

目的 探讨在点爆炸源颌面部致伤模型下 ,颌面部软组织损伤的组织学特点。方法 点爆源置于兔面部咬肌前缘中点上方 2cm处引爆 ,于伤后即刻、6h、2 4h、3d、7d ,用光镜、透射电镜观察距伤道 0～ 0 .5cm、0 .5～ 1.0cm、1.0～ 1.5cm处的相应皮肤、肌肉组织的病理改变。结果 软组织在距爆心不同距离表现为坏死、充血、水肿、肌纤维变性等不同的病理学改变。电镜下表现为线粒体肿胀 ,髓样变性 ,Z线排列紊乱 ,I带消失 ,M线模糊。结论 颌面部爆炸伤的初期清创范围应不小于 0 .5cm ,不应超过 1.0cm ,而皮肤的清创范围应在 0 .2cm。

Objective A bstract objective To investigate the histological alterations of maxillofacial soft tissue on the condition of a new type maxillofacial injury model with point blast source.Methods place the point blast sources at 2 cm obove the forward edge of the examined hare's facial masseter muscle and ignite to imitate blast wave. Take the soft tissue which are 0-0.5cm?0.5-1.0cm?1.0-1.5cm away from the injury area, observe the histological alterations with optical microscope and electron microscop at immediately?6h?24h?3d?7d after injury.Results soft tissue show various pathological alterations such as necrosis, injection, edema, muscle fiber degeneration, etc. we can find chondriosome swelling?degeneration, disorder of the Z line, disappear of I belt and obscure of Mline on the electron microscope.Conclusion The range of the primary reconstruction should be 0.5cm-1.0cm by soft tissue and 0.2cm by skin. It's similar to the blast injury by using detonator.