寒冷干燥环境下枪弹伤细菌学定量观察

Quantitative Bacteriological Study of Gunshot Wound in Cold and Dry Environment

目的：探讨寒冷干燥环境下火器伤细菌定量变化及感染发展过程与特征。方法：用40只兔的后肢制作成寒冷干燥环境下枪弹伤模型，对伤后1小时、3小时、6小时、12小时、24小时、48小时、72小时．96小时进行了大体观察和细菌学变化定量检测。结果：伤后24小时内伤道细菌缓慢增加，仅达10^4cfu/g，伤后48小时达引起感染的临界值10^5cfu/g，伤后72小时、96小时为10^6cfu/g，但仍未达10^8cfu/g，结果表明寒冷干燥环境对枪弹伤后伤道组织细菌量变化的影响非常大，寒冷干燥环境下枪弹伤感染速度及感染严重程度都明显低于常温条件下的枪弹伤。结论：寒冷干燥环境下火器伤的救治应有别于常温常湿条件，其早期伤道清创时限可适当放宽。

Objective: To investigate the change in quantity of bacteria and the development process and characteristics of the infection after gunshot in cold and dry environment. Methods: The model of gunshot wound at hind limb of rabbits in cold and dry environment was established. General observation and quantitative bacterial analysis were performed at1、3、6、2、24、48、72、96 hours after the injury respectively. Results: The levels of bacterial in wound tissue were increased 104cfu/g, 105cfu/g and 106cfu/g respectively at 24、48、72 and 96 hours after injury, within 48 hours, the bacteria reached the critical points for clinical infection. The results suggest that cold and dry affect strongly to change of bacteria level in tissue of gunshot wound, both the speed of infection development and serious extent of infection of gunshot wound in cold and dry environment were lower than those in regular temperature. Conclusion: The management of gunshot wound in cold and dry environment may be delay moderately in time of debridement and sewing.