寒冷干燥环境中肢体火器伤伤道细菌种类分析

QUALITATIVE BACTERIOLOGICAL ANALYSIS OF GUNSHOT WOUND ON LIMBS OF RABBITS IN COLD AND DRY ENVIRONMENT

目的 :探讨寒冷干燥环境下 ,肢体火器伤细菌种类与药敏试验。方法 :用 2 4只兔的后肢制作成寒冷干燥环境下火器伤模型 ,于伤后 1、3、6、12、2 4、4 8、72、96h进行生命体征观察、伤道分泌物细菌培养、分类及药物敏感试验 ,同时对动物皮毛、耙场空气等进行了细菌培养和分类。结果 :伤后动物呼吸、脉搏加快 ,体温下降 ,致伤后 2 4h呼吸、脉搏恢复正常 ,但体温仍低于致伤前 ;伤道分泌物细菌培养主要为G+ 菌 ,其次为G-菌 ,这些细菌对红霉素、丁胺卡那霉素、头孢类和喹诺酮类抗生素最敏感 ,对复方新诺明耐药 ,部分G-菌对青霉素、庆大霉素耐药。结论 :寒冷干燥环境下火器伤伤道细菌繁殖慢 ,伤道感染及细菌入血时间推后 ,认为这种特殊环境条件下的火器伤早期伤道清创时限可适当推迟 ,强调抗生素的使用应结合地域环境、气候条件等特点 ,早期联合使用抗生素。

Objective:To investigate flora analysis and drug susceptibility test of bacterium in the gunshot wound in cold and dry enviromnent.Method:The model of gunshot wound was established at hind limbs of 24 rabbits in cold and dry environment. At the time points of 1, 3, 6, 12, 24, 48, 72, 96h after injury, body temperature, pulse and respiration were measured, and bacterial culture, flora analysis and drug susceptibility test were performed in secretion of wound tract, air and snow at the shotting range.Result:Rate of respiration and pulse is faster, and body temperature is lower after injury than before injury. G + bacterium were most of them, the susceptibility antibioticogram were Erythromycinum, Amikacin, Cefazolin,Cefotaxime, Ofloxacin, Ciprofloxacin successively, they resisted the action of Sulfamethoxazolum, and G - bacterium resisted the action of Penicillin and Garamycin.Conclusion:The speed of infection development is slower and bacterial invasion into the blood is later in time in cold and dry environment than those in regular temperature. It is suggested that the management of gunshot wound in cold and dry environment may be delayed moderately in time of debridement and sewing, the antibiotics are emphasized by early and combined application according to characteristic of environment and climate of the area.