超声显像兔肺爆震伤的实验研究

Experimental study of lung blast injury in rabbits by ultrasonography

目的探讨不同程度兔肺爆震伤的超声图像特征。方法选取新西兰大白兔50只,建立轻、中、重度实验兔肺爆震伤模型(轻、中、重度致伤组各15只)和非致伤组5只,分别于爆震前后行超声检查观察各组肺部及胸腔变化情况,测定各组肿瘤坏死因子(TNF-α),并与病理结果对照分析。结果超声显示轻度致伤组少部分肺区见少许"彗星尾"征(同一切面小于3处);中度致伤组12只实验兔肺区见"彗星尾"征(同一切面占据整个切面1/2及以上),3只出现"白瀑布"征;重度致伤组13只实验兔表现为大面积的"白瀑布"征,2只合并气胸及胸腔积液。轻、中、重度致伤组爆震后即刻TNF-α均较其爆震前增大,差异均有统计学意义(均P<0.05),爆震后三组间及任意两组间TNF-α比较差异均有统计学意义(均P<0.05)。病理结果提示轻、中、重度致伤组实验兔肺出血、肺淤血及肺水肿依次加重。结论兔肺爆震伤具有显著的声像图特征,超声能较准确地评估肺爆震伤的范围和程度,可为临床早期诊断和后期救治提供重要的参考价值。

Objective To explore the ultrasonic imaging features of lung blast injury in different degrees in rabbits.Methods Fifty New Zealand white rabbits were selected,and animal models of mild,moderate and severe lung blast injury were established（each group has 15 rabbits）,non-injurious group has 5 rabbits.Changes in the lungs and chest wall were observed by ultrasonic imaging before and after the blast,and the TNF-α in each group was measured,the results was compared with patholog.Results The mild injured group showed a little＂comet tail＂in the lungs（the same section is less than three）,the moderate injured group showed＂comet tail＂can be found in 12 rabbits（＂comet tail＂occuped half and above of section）,the severe injured group showed＂white lung＂can be found in 13 rabbits,and 2 rabbits with pneumothorax and pleural effusion.The immediate TNF-αof all groups after blast were higher than that before blast,the differences were statistically significant（all P〈0. 05）. There were statistically significant differences in TNF-α after blast among three groups and between any two groups（all P〈0. 05）.The histopathological anatomy of the three groups showed that pulmonary hemorrhage,pulmonary congestion and pulmonary edema were aggravated orderly.Conclusion The lung blast injury has the characteristic of ultrasonography,and the ultrasound imaging can assess the range and intensity of the lung blast injury accurately,and it can provide important reference value for early clinical diagonsis and later treament.