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目的探讨犬水下冲击伤的处理原则。方法成年杂种犬61只,200、500、1 000g TNT水下爆炸致水下冲击伤,观察伤后6小时内动物存活情况、临床症状体征、动脉血气分析和形态学改变。结果本组动物存活38只,死亡23只,死亡率37.7%。形态学改变主要为不同程度的肺出血和肺水肿,胃肠道浆膜和黏膜下出血,高冲量时可引起胃肠道穿孔和肝脾破裂。轻度和中度伤动物除一过性体温降低外,临床未见明显改变,而重度以上损伤的动物可见呼吸加快、体温下降或不回升、心动过缓、口鼻流血性泡沫样液体、PaO2下降、PaCO2升高等,以极重度伤更为明显。结论保持呼吸道通畅,快速复温,容量复苏,维护心肺功能,防治呼吸功能不全、空气栓塞、D IC等并发症是水下冲击伤救治的原则。
Objective To investigate the treatment principle of canine underwater impact injury. Methods Totally 61 adult hybrid dogs were killed by underwater blasting with 200,500,1 000 g TNT. Survival, clinical symptoms and signs, arterial blood gas analysis and morphological changes within 6 hours after injury were observed. Results This group of animals survived 38, dead 23, the mortality rate was 37.7%. Morphological changes are mainly different degrees of pulmonary hemorrhage and pulmonary edema, gastrointestinal serosa and submucosal hemorrhage, high doses can cause gastrointestinal perforation and rupture of liver and spleen. Mild and moderately injured animals in addition to a transient decrease in body temperature, the clinical no significant change, while severe injury animals can be seen faster breathing, decreased body temperature or does not rise, bradycardia, nasal bloody foam-like liquid, PaO2 Decline, PaCO2 increased, with very serious injuries more obvious. Conclusions Maintaining the respiratory tract patency, rapid rewarming, volume recovery, maintenance of cardiopulmonary function, prevention and treatment of respiratory insufficiency, air embolism, D IC and other complications are the principles of underwater shock treatment.