摘要
目的:研究模拟深埋条件下持续性挤压伤复合低氧缺水缺食大鼠的生命耐受力、肺脏功能及病理变化特点。方法:应用Wistar雄性大鼠144只,随机分为正常对照组、单纯挤压伤组、低氧缺水缺食组(三缺组)、挤压伤复合低氧缺水缺食组(复合组),采用钳夹双后肢近端方法建立挤压伤模型,压力设置(4.5±0.3)kg,于致伤后第1天、第3天、第5天、第7天、第9天、第11天检测大鼠动脉血气参数(PaCO_(2)、PaO_(2)),切取肺脏,常规制片,光镜和电镜观察,Tunel法检测肺脏细胞凋亡,SP法检测凋亡相关因子Bax和炎性因子TNF-α。结果:1.复合组大鼠于伤后第7天内全部死亡,三缺组于第11天内全部死亡,单纯挤压伤组和正常对照组未死亡。2.三缺组和复合组血PaCO_(2)和PaO_(2)值呈急剧持续性显著降低至死亡;单纯挤压伤组PaCO_(2)轻度升高、PaO_(2)呈下降趋势。3.复合组肺脏指数增高,以充血、血停滞、点灶状出血、轻度到中度水肿等血循环障碍为主,并有数量不等的血栓(红血栓,弥散性血管内凝血)形成和小叶局灶性间质性肺炎样改变,从第4天直到第7天时血循环障碍则明显加重,三缺组和单纯挤压伤组依次减轻。结论:挤压伤复合低氧缺水缺食大鼠肺脏功能和结构发生明显损伤,具有高发性、进行性、全肺性特点,提示肺脏是加重复合性挤压伤并发多器官功能障碍衰竭,促进死亡的重要远隔脏器之一。
Objective:To study the life tolerance and lung function and pathological changes of rats subjected to continuous crush injury combined with hypoxia and deprivation of water and food under simulant deeply buried condition.Methods:One hundred and forty four male Wistar rats were randomly divided into four groups:control group,crush group,hypoxia combined with deprivation of water and food group(three lack group),and crush injury combined with hypoxia and deprivation of water and food group(combined group).The crush injury model was established by clamping the proximal ends of double hind limbs with the pressure set as(4.5±0.3)kg.The arterial blood gas(PaCO_(2),PaO_(2))in rats was measured at 1,3,5,7,9 and 11 days after injury,respectively.The lung of the rat was incised,and the histological section was made.The lungs were observed under optical and electronic microscopes.Apoptosis of lung cells was detected by TUNEL staining.The expression of Bax and TNF-αrelated to apoptosis and inflammation was examined by SP method.Results:In the combined group,all rats died within 7 days after injury.All rats died within 11 days after injury in the three lack group.No death was observed in the control group and the crush group.PaCO_(2)and PaO_(2)in the combined group and the three lack group decreased rapidly until death.PaCO_(2)mildly increased,while PaO_(2)mildly decreased in the crush group.In the combined group,the lung index was increased,and the pathological changes were mainly disturbance of blood circulation such as hyperemia,blood stagnancy,local hemorrhage,low-grade to middle-grade dropsy.Several thrombus(red thrombus,disseminated intravascular coagulation)and lobular interstitial pneumonia were also observed,and the disturbance of blood circulation obviously aggravated from the fourth day to the seventh day.The pathological changes of the three lack group and the crush group were in order alleviated.Conclusion:The functional and structural changes of lungs are obvious in rats subjected to crush injury combined with
作者
刘志瑞
王德文
左红艳
王少霞
郭晓明
王静雯
曹桓荣
LIU Zhi-rui;WANG De-wen;ZUO Hong-yan;WANG Shao-xia;GUO Xiao-ming;WANG Jing-wen;CAO Huan-rong(Institute of Radiation Medicine,Academy of Military Medical Sciences,Beijing 100850,China)
出处
《灾害医学与救援（电子版）》
2013年第1期4-10,共7页
Disaster Medicine and Rescue(Electronic Edition)
基金
国家科技部709项目(No.2006FK130006)
关键词
模拟深埋条件
复合性挤压伤
大鼠
肺脏
持续挤压
simulant deeply buried condition
combined crush injury
rat
lung
continuous crush
