兔角膜爆炸伤后海水浸泡的实验观察

Changes in corneal morphology after seawater soaking following explosive injury in rabbits

目的 :通过对兔眼爆炸伤后角膜组织裂隙灯和光镜下改变的观察 ,确定海水浸泡对角膜爆炸伤后组织病理改变的影响 ,为沿海作战中对角膜爆炸伤后的防治提供依据。 方法 :对 2 0只成年灰兔造成近乎相同的双眼爆炸伤模型。右眼为实验眼 ,左眼为对照眼。实验眼海水浸泡 0 .5h ,对照眼等渗盐水浸泡 0 .5h。伤前和伤后1、2、3、4、5、7、9、10、15和 2 0天分别进行角膜裂隙灯检查、角膜荧光素染色、超声角膜厚度测定 ,按期、按序取角膜标本进行光镜下对比观察。角膜厚度值分别进行伤前与伤后自身对照t检验 ,实验眼和对照眼t检验。 结果 :伤后裂隙灯下见角膜明显混浊水肿 ,1～ 7天角膜荧光素染色呈不同程度着色 ,15天后角膜出现明显血管化。实验眼比对照眼角膜混浊明显加重 ,荧光着色时间延长 ,血管化明显提前并加重。光镜下对比观察显示 :爆炸伤后角膜组织上皮缺损 ,角膜基质炎细胞浸润并逐日加重 ,伤后 5～ 7天对照眼角膜上皮层再生 ,角膜基质有大量新生血管。实验眼角膜组织的损伤改变明显加重 ,愈合延迟 ,角膜基质血管化程度加重。角膜厚度伤后均较伤前明显增加 ,实验眼更为明显 ,角膜厚度值与伤前自身对照和实验眼与对照眼经分组t检验 ,差异均有显著性意义。 结论

Obiective: To observe the changes in corneal tissue after seawater soaking following explosive injury in rabbits and the effects of seawater soaking on the healing of cornea after explosive injury. Methods:Make 20 similar explosive injury models of rabbit's eyeball using 10 adult grey rabbits. For each rabbit, the right eye was in experiment and the left one was for comparison. After the injury, the experimental eyes were soaked in seawater for 30 minutes and the comparable eyes were soaked in 0.9% sodium chloride injection for the same time. All eyes were underwent slit lamp examinations, fluorescein dyeing, and ultrasonic cornea thickness metering on the corneas before the injury and 1,2,3,4,5,7,9,10,15 and 20 days after the injury respectively. At the same time, 2 rabbits were killed and the eyes were examined pathologically. The cornea thickness numbers were compared using self- comparison t test and grouping t test. Results: After seawater soaking following explosive injury, slit lamp microscope examination found that the corneas were edema and turbidity, the experimental eyes were stricter than the control eyes. The corneas of the experimental eye were vascularized 10 days after the injury. Fluorescein dyeing showed that more apparent pigmentations were found on the experimental eyes than that on the control ones.Comparative examination under the optical microscope showed that the corneal tissues of the experiment eyes changed distinctly, their inflammations were patency and healing was delayed and the vascularization degree became high after the injury. Cornea thickness of the experimental eyes became apparently thicker than that of the control eyes. The difference was statistically significant. Conclusion:Scars and vascularization of various degrees will appear in corneal stroma after the explosive injuries. Seawater soaking will have bad effects on the healing of the cornea injured in explosions.