摘要
目的探讨高原环境下猪肠管火器贯通伤的早期凝血功能变化特点。方法选取20头健康长白仔猪,按随机数字表法分为平原组、高原组,每组10只。平原组放置于海拔800 m的平原境中,高原组放置于模拟海拔6000 m高原的实验舱中48 h。两组均手枪致腹部肠管火器贯通伤后返回平原观察室。各组伤后0、2、4、8、12及24 h分别检测外周血凝血和纤溶指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fbg)、D⁃二聚体(D⁃D)、纤维蛋白降解产物(FDP)]、血栓弹力图(TEG)[凝血反应时间(R值)、血凝块形成时间(K值)、血凝块形成速率(α角)、血凝块最大强度(MA)、凝血综合指数(CI)]、血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、大型血小板比率(P⁃LCR)]。结果高原组伤后0、2 h PT均较平原组显著降低,伤后8、12、24 h PT均较平原组显著升高(P<0.01);伤后4 h PT与平原组差异无统计学意义(P>0.05)。高原组伤后0、2、4 h APTT均较平原组显著降低,伤后8、12、24 h APPT均较平原组显著升高(P<0.01)。高原组伤后0、2、4 h TT均较平原组显著降低,伤后12、24 h TT均较平原组显著升高(P<0.01);伤后8 h TT与平原组差异无统计学意义(P>0.05)。高原组伤后0、2、4、8、12、24 h Fbg、D⁃D、FDP均较平原组显著升高(P<0.01)。高原组伤后0、2、4 h R值均较平原组显著降低,伤后8、12、24 h R值均较平原组显著升高(P<0.01)。高原组伤后0、2、4 h K值均较平原组显著降低,伤后8、12、24 h K值均较平原组显著升高(P<0.05或0.01)。高原组伤后0、2、4 hα角均较平原组显著升高,伤后8、12、24 hα角均较平原组显著降低(P<0.01)。高原组伤后0、2、4、8 h MA值均较平原组显著升高,伤后12、24 h MA值均较平原组显著降低(P<0.01)。高原组伤后0、2、4 h CI值均较平原组显著升高,伤后8、12、24 h CI值�
Objective To explore the early coagulation function changes of penetrating intestinal firearm injury of pig in high⁃altitude environments.Methods Twenty healthy long white piglets were selected and divided into the plain group and the high⁃altitude group using the random number table method,with 10 pigs in each group.Pigs in the plain group were placed in a plain environment at an altitude of 800 meters,while pigs in the high⁃altitude group were placed in an experimental chamber simulating an altitude of 6000 meters for 48 hours.Both groups received pistol gunshot to have firearm penetrating wounds to the abdominal intestinal tract and then returned to the plain observation room.At 0,2,4,8,12 and 24 hours after injury,coagulation in the peripheral blood and fibrinolytic indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fbg),D⁃dimer(D⁃D),and fibrinogen degradation product(FDP)],thromboelastogram(TEG)[reaction time(R),clotting time(K),clot formation rate(α),maximum amplitude(MA)and coagulation composite index(CI)],platelet parameters[platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),and platelet⁃large cell ratio(P⁃LCR)]in the two groups were detected separately.Results The PT values at 0 and 2 hours after injury in the high⁃altitude group were significantly lower than those in the plain group,while they were significantly higher at 8,12 and 24 hours than those in the plain group(P<0.01);there was no significant difference at 4 hours between the two groups(P>0.05).The APTT values at 0,2 and 4 hours after injury in the high⁃altitude group were significantly lower than those in the plain group,while they were significantly higher at 8,12 and 24 hours after injury than those in the plain group(P<0.01).The TT values at 0,2 and 4 hours after the injury in the high⁃altitude group were significantly lower than those in the plain group,while they were significantly higher at 12 and 24 hours after injury than those in the pl
作者
孙赳
杨雪
屈金权
杨欣悦
沈才福
李佳佳
邢颜超
刘江伟
Sun Jiu;Yang Xue;Qu Jinquan;Yang Xinyue;Shen Caifu;Li Jiajia;Xing Yanchao;Liu Jiangwei(Graduate School of Xinjiang Medical University,Urumqi 830054,China;Key Laboratory of SpecialEnvironmental Medicine of Xinjiang,General Hospital of Xinjiang Military Command,Urumqi 830000,China)
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2024年第3期257-265,共9页
Chinese Journal of Trauma
基金
军队实验动物专项科研课题[SYDW(2017)11号]。
关键词
肠
腹部损伤
创伤
贯通性
火器
高原
Intestines
Abdominal injuries
Wounds,penetrating
Firearms
High altitude
