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目的:探讨颅脑枪弹伤后病理生理变化。方法:采用德国小口径步枪子弹随机致犬颅脑贯通伤(penetratingcran-iocerebralinjury,PCI)组及脑切线伤(tangentbraininjury,TBI)组模型。记录致伤前后呼吸、心率、心电图、平均动脉压、脑血流、脑电图等病理生理改变。结果:动物伤后均出现呼吸暂停,伤后动物平均呼吸暂停时间PCI组5.3min明显长于TBI组1.7min(P=0.0118),出现心率减慢、平均动脉压降低、动脉血流量减少等脑干抑制现象;颅内压逐渐升高;脑电活动消失,脑电图呈一直线;动物伤后平均存活时间,TBI组568min明显长于PCI组106min(P=0.0013)。结论:①伤后动物出现呼吸抑制、心率减慢和血压降低等短暂性抑制,积极有效的辅助呼吸能减少颅脑枪弹伤动物的死亡率。②颅内高压出现早且明显。③该模型伤后动物存活时间长,尤以TBI组更为理想。
Objective: To investigate the pathophysiological changes of craniocerebral gunshot wounds. METHODS: German small-caliber rifle bullets were randomly divided into two groups: the dogs in penetrating cranial irebralinjury (PCI) group and the tangent brain infarct (TBI) group. Record before and after injury breathing, heart rate, electrocardiogram, mean arterial pressure, cerebral blood flow, electroencephalogram and other pathophysiological changes. Results: The animals all had apnea after injury, and the average duration of animal death was 5.3 minutes in PCI group and 1.7 minutes in PCI group (P = 0.0118). The brainstem appeared to be slowed down, mean arterial pressure decreased and arterial blood flow decreased The intracranial pressure gradually increased; the electroencephalogram disappeared and the electroencephalogram showed a straight line; the mean survival time of the animals after injury was 568min in TBI group, which was significantly longer than 106min in PCI group (P = 0.0013). Conclusion: ①The animals showed transient inhibition of respiratory depression, heart rate and blood pressure reduction after injury. Active and effective assisted breathing can reduce the mortality rate of craniocerebral gunshot wound animals. ② intracranial hypertension appeared early and obvious. ③ The model of animal survival after injury for a long time, especially TBI group is more ideal.