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目的:探讨海水浸泡弹烧复合伤伤后细菌学变化与常用药物的作用结果,为该类复合伤早期使用合理抗生素提供理论依据。方法:成功建立海水浸泡弹烧复合伤模型后,将15只成年杂种犬随机分为单纯弹烧复合伤组(简称非浸泡组7只)和海水浸泡弹烧复合伤组(简称浸泡组8只),于伤后即刻、4、6、10、20、28 h共6个时相点抽取静脉血进行血细菌培养,随机采集培养后的细菌(不记种类),分别用环丙沙星、丁胺卡拉霉素、庆大霉素、头孢哌酮等4种药物进行药敏实验。结果:弹烧复合伤动物经海水浸泡后菌血症出现早而且重;导致菌血症的细菌来源复杂,不仅有肠道菌群,还有海水特有菌群和皮肤常驻菌群;在实验所用的4种药物中,有效率分別是:环丙沙星85%、丁胺卡拉霉70%、庆大霉素80%、头孢哌酮75%。结论:在海水浸泡弹烧复合伤中,伤后早期就可出现严重的菌血症;在不考虑菌血症细菌种类的情况下,环丙沙星有较好的总体疗效。
Objective: To explore the effect of bacteriological changes and common drugs after seawater immersion and burn combined injury, and to provide a theoretical basis for early use of rational antibiotics in such composite wounds. Methods: After successful establishment of sea-water immersion-bomb combined burn injury model, 15 adult mongrel dogs were randomly divided into two groups: simple-burn combined injury group (referred to as non-immersion group) and seawater immersion combined burn injury group ). Blood samples were collected from 6 venous blood samples at 6, 6, 10, 20, and 28 h after injury. Bacterial cultures were collected randomly (no record). Ciprofloxacin, Amikacin, gentamicin, cefoperazone and other four drugs susceptibility testing. Results: Bacillus amyloliquefaciens had early and severe bacteremia after seawater immersion. The bacterium causing bacteremia had complicated sources of bacteria, including not only intestinal flora but also seawater-specific flora and skin resident flora. In the experiment Among the four drugs used, the efficiencies were 85% for ciprofloxacin, 70% for K. butyricum, 80% for gentamicin and 75% for cefoperazone. CONCLUSIONS: Severe bacteremia can occur in the early stages of injury after immersion in a seawater immersion bomb. In general, ciprofloxacin has a good overall effect regardless of the bacterial species of bacteremia.