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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 study the characteristics and laws of wound infection after gunshot wounds in the Cold War environment during the Cold War in Plateau. Methods Thirty miniature pigs were randomized into GZ, GP and PP groups. The wound infection was observed at different time points after injury In addition, the 1.0 cm deep tissue in the entrance to the injured area was tested for bacteriological and endotoxin levels. Results (1) The total amount of bacterial contamination in the injured wounds of the two groups in the plateau was an order of magnitude less than that of the plain group. (2) Bacterial resuscitation time in PP group was 0 ~ 3h after injury; resuscitation was done 6 ~ 12h after injury in GP and GZ groups. (3) The number of bacteria in wound group of PP increased from 105 to 6 hours of 105 to 12 hours of 107, which took 6 hours; (4) The total endotoxin levels in the GP and GZ groups were significantly lower than those in the PP group. (5) The critical number of bacteria in group PP infected with wound infection was 105cfu / g wet tissue, the duration of infection was 6-12h after injury; the critical number of bacteria infected by wounds in group GP was 107cfu / g wet tissue, 72h. The number of critical bacteria in GZ group wounds was 106cfu / g wet tissue, and the duration of wound tissue infection was 24-36h after wounding. (2) The plateau bacteria resumed after 3 ~ 9h later than the plain areas; (3) The bacteria in plateau wounds were slower than the plain areas; (4) (5) The time limit of plateau infection was delayed and the critical number of bacteria causing infection increased, followed by GP> GZ> PP.