摘要
目的研究高原寒区平战时环境下枪弹伤后伤道感染的特点和规律。方法将30头小型猪随机分为高原战时致伤组(GZ)、高原平时致伤组(GP)和平原平时致伤组(PP),分别于伤后不同时相点观察伤道入口感染情况,并取伤道入口内1.0cm深处组织进行细菌学和内毒素水平测定。结果 (1)高原两组伤道污染细菌的总量较平原组少一个数量级。(2)PP组伤后细菌复活定植的时间在伤后0～3h;GP和GZ组在伤后6～12h完成复活定植。(3)PP组伤道细菌数从6h的105繁殖到12h的107,用了6h;而GP组伤道细菌从24h的105繁殖到48h才达到107,用了24h。(4)GP和GZ组伤道污染菌的总内毒素水平显著低于PP组。(5)PP组引起伤口感染的细菌临界数量为105cfu/g湿组织,感染时限在伤后6～12h;GP组枪弹伤伤口感染的细菌临界数量为107cfu/g湿组织,感染时限为48～72h;GZ组枪弹伤感染的临界细菌数量为106cfu/g湿组织,伤道组织感染时限为伤后24～36h。结论 (1)高原枪弹伤伤道细菌污染较平原地区轻;(2)高原细菌的复活定植时间较平原地区晚3～9h;(3)高原伤道内细菌的繁殖速度较平原地区慢;(4)高原伤道污染菌的内毒素毒力显著较平原地区低;(5)高原感染时限延迟,引起感染的细菌临界数量提高,依次为GP>GZ>PP。
Objective To investigate the features and rules of gunshot wound track infection at high altitude in a wartime or peacetime environment. Methods 30 pigs were randomly divided into GZ group （n = 10） , GP group （n = 10） and PP group （ n = 10）. Pigs in GZ group were sent to high altitude（ 3670 m above sea level）from plain（ 351 m above sea level）and lived in a simulated wartime environment for 3 days until their hind limbs were wounded by gunshot. Animals in GP group were also sent to the same high altitude but lived in a normal environment for 14 days and then suffered from gunshot wounds,while those in PP group Were fed under normal conditions in plain （351 m above sea level）and injured thereafter. The infection conditions at the entrance of wound track were observed at different time points after injury. Tissues at 1 cm below the entrance of wound track were taken for bacteriological and endotoxin level measurement. Results （ 1 ） The bacterial amount of wound track in PP Group was 1.0 times higher than those in GP group and GZ group. （2） The time of bacterium settling down was 0 to 3 hours after injury in PP group and 6 to 12 hours in GP and GZ groups. （ 3 ） It took 6 h for the bacterial amount of wound track to grow from 105 at 6 h to 107 at 12 h after injury in PP group, while in GP group, it took 24 h to grow from 105 at 24 h to 107 at 48 h after injury. （4）The total endotoxic levels of wound track bacterium in GP group and GZ group were significantly lower than that in PP Group. （ 5 ） In PP Group, the critical amount of bacterium that caused wound infection was 10^5 cfu per gram wet tissue,and the time limit of infection was 6 to 12 h after injury,while in GP group and GZ group, the critical amount of bacterium was 10^7 and 10^6 cfu per gram wet tissue, respectively, and the time limit of infection was 48 - 72 h and 24 - 36 h, respectively. Conclusion （ 1 ） The bacterial contamination of gunshot wound track at high altitude is milder than that in plain. （2） The settling down time of bacterium at high altitude is 3 - 9 h later than that in plain. （3） The bacterial breeding velocity is slower at high altitude than that in plain. （4）The endotoxic virulence of bacterium in a wound track at high altitude is significantly lower than that in plain. （ 5 ） At high altitude, the time limit of infection may delay and the critical amount of bacterium causing wound infection may increase. The ranked order from the highest to the lowest was GP, GZ and PP group.
出处
《西南国防医药》
CAS
2010年第10期1113-1116,共4页
Medical Journal of National Defending Forces in Southwest China
基金
军队指令性课题资助项目(01L008)
关键词
高原
枪弹伤
伤道
感染
high altitude
gunshot wound
wound track
infection
