论文部分内容阅读
目的:研究低温条件下火器性骨折的损伤特点,探讨早期恢复骨连续性的方式方法,为寒区火器性骨折的治疗提供参考。方法:采用东北地区杂种犬24只,标准驯养二周后,随机分成伤后8小时、24小时内固定和外固定组(n=6),致伤前动物及弹丸同时置-40℃条件下1小时,3%戊巴比妥纳静脉麻醉,迅速移到室外靶道(—20℃),射距20米,犬单后肢股骨中段致伤。伤后8小时、24小时无菌操作下取伤道组织、抽血、并进行清创,观察局部损伤效应,分别进行钢板螺丝钉内固定和外固定手术。术后自由摄食喂养,并进行局部情况、引流量、体温、血常规及血培养等观察。结果:低温条件下火器性骨折局部损伤效应较常温条件下重,伤后8小时,伤道组织菌量增加缓慢,仅达10~4cfu/g,伤后24小时达10~6cfu/g,内固定组与外固定组炎症反应、骨愈合时间无明显差异(P>0.05)。结论:提示低温对火器伤后伤道组织的菌量变化有明显影响,组织厚度小于10cm,彻底清创、良好引流前提下早期骨折内固定具有一定可行性。
OBJECTIVE: To study the characteristics of firearm fractures under low temperature conditions and to explore ways and means of early recovery of bone continuity, so as to provide a reference for the treatment of firearm fractures in cold regions. Methods: Twenty-four crossbred dogs in northeastern China were used. After two weeks of standard domestication, rats were randomly divided into 8 hours after injury, fixed and external fixation group (n = 6) within 24 hours, One hour, 3% pentobarbital intravenous anesthesia, quickly moved to the outdoor target track (-20 ℃), shooting 20 meters, the middle of the hind limbs canine midrib injury. Twenty-eight hours after injury, the wound tissue was removed under aseptic operation for 24 hours, blood was taken and debridement was performed. The local lesion effect was observed. The internal fixation and external fixation of the plate were respectively performed. Free feeding after surgery, and local conditions, drainage, body temperature, blood and blood culture observation. Results: The local injury of firearm fracture was heavier than that of normal temperature at low temperature. After 8 hours of injury, the amount of bacteria in wound tissue increased slowly, reaching only 10 ~ 4cfu / g and 10 ~ 6cfu / g within 24 hours after injury There was no significant difference in inflammatory reaction and bone healing time between fixed group and external fixation group (P> 0.05). Conclusion: It is suggested that low temperature has a significant effect on the bacterial volume changes of wound tissues after firearm wounds. The thickness of the tissue is less than 10cm and debridement is complete. It is feasible to fix early fracture with good drainage.