大动脉破裂出血合并局部组织缺损动物模型制备与评价

Preparation and evaluation of animal model of major artery rupture and hemorrhage complicated with local tissue defect

目的建立大动脉破裂出血合并局部组织缺损动物模型,为战伤救治实战化训练和考核提供可靠的动物模型。方法选取18头4~6个月龄健康长白猪为研究对象。将其随机分为空白组、对照组、实验组,每组各6头。3组实验猪均采用相同的麻醉方法与造模准备。空白组仅解剖显露股动脉,不予动脉造模损伤。对照组造模后不予救治干预。实验组造模后由6名医师行止血、包扎等操作。造模2 min后,记录3组实验猪的生命体征、血常规、出血量等。记录实验组模型止血训练情况。设计一种新型战伤动物模型评价方法(100分制),记录不同受训人员对实验动物模型的评分。结果对照组脉搏、呼吸频率均高于空白组,平均动脉压、血氧饱和度、体温均低于空白组,差异均有统计学意义(P<0.05);实验组脉搏、呼吸频率均低于对照组,平均动脉压、血氧饱和度、体温均高于对照组,差异均有统计学意义(P<0.05)。对照组红细胞数、血红蛋白、血小板计数均低于空白组,出血量高于空白组,差异均有统计学意义(P<0.05);实验组红细胞数、血红蛋白、血小板计数均高于对照组,出血量低于对照组,差异均有统计学意义(P<0.05)。实验组中,受训人员对伤情真实感、模型参数、麻醉与伦理、模型推广性、训练效果、考核要素6个方面给予动物模型评价较高,分数>9分;对模型标准化、造模难度、造模时间、造模工具4个方面评价较低,分数≤9分。结论大动脉破裂出血合并局部组织缺损动物模型成功建立,能够基本满足战伤救治实战化训练和考核需求。

Objective The animal model of major artery rupture and hemorrhage complicated with local tissue defect was established to provide a reliable animal model for the training and assessment of combat injury treatment.Methods Atotal of 18 healthy landrace pigs aged 4 to 6 months were selected as the study subjects.They were randomly divided into blank group,control group and experimental group,with 6 heads in each group.The three groups of pigs were treated with the same anesthesia method and modeling preparation.In the blank group,only the femoral artery was dissected,without the artery modeling injury.The control group was not treated after modeling.The experimental group was treated with hemostasis and bandaging by 6 physicians after modeling.After 2 minutes of modeling,the vital signs,blood routine and blood loss of the three groups of experimental pigs were recorded.The hemostatic training of the experimental group model was recorded.A new evaluation method of animal models of war injury(100 points scale)was designed to record the scores of different trainees on experimental animal models.Results Pulse and respiration of control group were higher than blank group,average arterial pressure,oxygen saturation and body temperature were lower than blank group,the differences were statistically significant(P<0.05).The pulse and respiration of the experimental group were lower than those of the control group,while the average arterial pressure,oxygen saturation and body temperature were higher than those of the control group,with statistical significance(P<0.05).The erythrocyte count,hemoglobin and platelet count of control group were lower than that of blank group,and the blood loss was higher than that of blank group,with statistical significance(P<0.05).The erythrocyte count,hemoglobin and platelet count of the experimental group were higher than those of the control group,but the blood loss was lower than that of the control group,with statistical significance(P<0.05).In the experimental group,the trainees evaluated the animal model highly in six aspects,namely,sense of reality of injury,model parameters,anesthesia and ethics,model extensibility,training effect and assessment elements,and the score was>9.The four aspects of model standardization,difficulty,time and tools were evaluated low,with the score≤9.Conclusion The animal model of major artery rupture and hemorrhage combined with local tissue defect has been successfully established,which can basically meet the requirements of practical training and assessment in the treatment of war wounds.