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目的探讨高原高寒环境下平战时肢体枪弹伤后血浆电解质代谢的特点。方法将24头实验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),每组8头。分别于伤前、伤后30分钟2、6、、12小时1、2、3、、5、7、10、14天采静脉血测定钾、钠、氯和钙、镁、磷的含量。结果伤后平原平时组和高原平时组血钙有明显的下降趋势,高原平时组整体血钙水平均较平原组低,但血清钙>2.25mmol/L。而高原战时组伤后3～5天有较严重的低钙血症。三组枪弹伤后均出现严重的低镁血症,严重程度依次为高原战时组>高原平时组>平原平时组。高原战时组伤后2小时即有显著降低,伤后12小时测不出,一直到伤后3天持续在低水平。三组伤后6小时血钠有一个显著的升高,受伤12小时后三组血钠逐渐降低,至伤后7天时高原战时组出现轻度低钠血症。三组K+、Cl-和Pi3+均在伤后12小时开始逐渐降低,严重程度依次为高原战时组>高原平时组>平原平时组,但都未低于正常值的低限。结论高原战时枪弹伤后3～5天机体有严重的低钙血症,6小时～1天和3天机体有严重的低镁血症;12小时后机体开始出现K+、Na+、Cl-和Pi3+的逐渐降低,至伤后7天出现轻度的低钠血症。
Objective To explore the characteristics of plasma electrolyte metabolism after gunshot wounds in Pinghu westerly in the high altitude and alpine environment. Methods Twenty-four experimental pigs were randomly divided into three groups: GZ group, GP group and PP group. Venous blood samples were collected for determination of potassium, sodium, chloride and calcium, magnesium, and phosphorus at pre-injury, 30 minutes after injury 2,6, and 12 hours 1,2,3 and 5,7, and 10, respectively. Results The levels of serum calcium in the plain group and the plain group were significantly decreased after injury. The level of serum total calcium in the plain group was lower than that in the plain group, but the serum calcium was 2.25 mmol / L. The wilderness group of wounded 3 to 5 days after injury more severe hypocalcemia. Three groups of gunshot wounds were severe hypomagnesemia, the severity of the order of the wilderness wilderness group> plain group> plain group. At 2 hours after injury, the Wushu group in the wilderness reduced significantly after 12 hours of injury and remained undetected for 3 days after injury. Six hours after injury, there was a significant increase in serum sodium in the three groups. After 12 hours of injury, the serum sodium of the three groups gradually decreased, and mild hyponatraemia occurred in the wilderness group at 7 days after injury. Three groups of K +, Cl- and Pi3 + began to reduce gradually 12 hours after injury, the severity of the order of the wilderness group> plain group> plain group, but not below the lower limit of normal. CONCLUSIONS: Severe hypocalcemia occurred in 3 to 5 days after the gunshot wounds in the highland wartime, and severe hypomagnesemia occurred in 6 hours to 1 day and 3 days. After 12 hours, K +, Na +, Cl- and Pi3 + gradually decreased to 7 days after injury mild hyponatremia.