模拟深埋条件下复合性冲击伤生命耐受力与伤情特点研究——生命耐受力和血气分析

Study on thhe tolerance of life and the characteristics of injuries of complicated blast injury under the condition of simulated deeply buried——The tolerance of life and blood-gas analysis

目的:探讨模拟深埋条件下复合性冲击伤比格犬和大鼠生命耐受力及血气指标的变化规律。方法:成年Wistar大鼠344只,比格犬18只,均雌雄各半。血气检测大鼠随机分为对照组、单纯低氧组、缺水缺食组、低氧缺水缺食组、单纯冲击伤组、冲击伤复合缺水缺食组、冲击伤复合低氧缺水缺食组,血气检测时间为第1、3、5、7天,全自动血气分析仪检测动脉血酸碱度（pH）、血氧分压（PaO2）、二氧化碳分压（PaCO2）;生命耐受大鼠和犬分为4、5、7组,均持续观察至全部死亡。冲击伤模型采用TNT高爆炸药致伤,低氧模型动物均置于10%全自动常压低氧舱内,缺水缺食模型均不予水食供给。结果:（1）大鼠单纯冲击伤无死亡,低氧缺水缺食组于10.415.8天全部死亡,冲击伤复合低氧缺水缺食组于9.515.2天死亡,其中雄性最早死亡时间、最迟死亡时间和平均活存时间均缩短;比格犬单纯冲击伤组无死亡,低氧缺水缺食组于11.914.9天死亡,冲击伤复合低氧缺水缺食组10.916.7天死亡,雄性死亡发生时间同样早于雌性。（2）动脉血pH值于第17天各伤类组均未见明显变化,PaO2值于所有低氧组皆较未低氧组显著降低,于伤后第1天即明显降低,并呈持续性,尤以冲击伤复合低氧缺水缺食组雄性明显;PaCO2值于冲击伤复合低氧缺水缺食组明显低于单纯冲击组和冲击伤复合缺水缺食组,冲击伤复合缺水缺食组动物的PaCO2随观察时间的延长而呈逐渐升高趋势。结论:低氧缺水缺食可加重爆炸所致冲击伤伤情,加速死亡,缩短生命耐受时间,雌性的生存能力强于雄性;PaO2和PaCO2值降低,具有发生迅速性、高发性、持续性、雄性重于雌性特点。

Objective:To study the tolerance of life and the changed rules of blood-gas indexes of complicated blast injury in beagles and rats under the condition of simulated deeply buried. Methods:344 adult Wistar rats and 18 beagles with half males and half females were used. Wistar rats randomly were divided into the control group,pure hypoxia group,deprivation of water and food group,hypoxia combined with deprivation of water and food group,pure blast injury group,blast injury combined with deprivation of water and food group,blast injury combined with hypoxia and deprivation of water and food group. Blood-gas were measured at 1,3,5 and 7 day after injury. Arterial blood pH、PaO-_2、PaCO_2 were measured;Rats and beagles of the tolerance of life were divided 4、5、7 groups. All are constant observed to death. Blast injury model was made by using TNT high explosive injury, hypoxia model animals were placed in 10% full automatic atmospheric hypoxia cabin, lack of water and food model were not with water and food supply. Results:(1)There was no death in rats' pure blast group whereas all were dead of three deprivation group at 10.4~15.8 days and all were dead of blast with three deprivation group at 9.5~15.2 days after injury. The earliest time of death, the latest time of death and the mean survival time were shortened in males. There was no death in beagles' pure blast group whereas all were dead of three deprivation group at 11.9~14.9 days and all were dead of blast with three deprivation group at 10.9~16.7 days after injury. The moment of death occurred in males were the same earlier than females.(2)Arterial blood pH had no significant changes among the injured groups of 1~7 days. PaO_2 in all the hypoxia groups was significant lower than those of no hypoxia groups. PaO_2 was significant decreased at 1 day after injury and continuative lowered,especially in the males of blast with three deprivation group. PaCO_2 in blast with three deprivation group was significant lower than pure blast group and blast with two deprivation group.PaCO_2 of blast with two deprivation group showed a gradually increased tendency with the extension of observation time.Conclusions:Hypoxia and deprivation of water and food group could aggravate the blast injury,accelerate death and shorten the time of lives' tolerance caused by explosion. Survival ability of females was stronger than males;Both PaO_2 and PaCO_2 were lowered with the characteristics of speedy,high incidence and sustainability,besides those,the injuries of males were more severity than females.