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[1]周松,张文华,邵志鸿,等.便携式腹腔灌洗装置的研制及其对海水浸泡腹腔开放伤犬的救治研究[J].医学研究与战创伤救治(原医学研究生学报),2018,20(01):11-17.[doi:10.3969/j.issn.1672-271X.2018.01.003]
　ZHOU Song,ZHANG Wen-hua,SHAO Zhi-hong,et al.Development of portable peritoneal lavage device and the treatment research of open abdominal injury dogs in seawater immersion[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2018,20(01):11-17.[doi:10.3969/j.issn.1672-271X.2018.01.003]
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便携式腹腔灌洗装置的研制及其对海水浸泡腹腔开放伤犬的救治研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第20卷
期数:
2018年01期
页码:
11-17
栏目:
出版日期:
2018-01-22

文章信息/Info

Title:
Development of portable peritoneal lavage device and the treatment research of open abdominal injury dogs in seawater immersion
作者:
周松; 张文华; 邵志鸿; 叶清林; 钟伟; 林晓强; 陈月凤; 王小文
作者单位：363000漳州，解放军第175医院普通外科（周松、张文华、邵志鸿、叶清林、钟伟、林晓强、陈月凤、王小文）
Author(s):
ZHOU Song;  ZHANG Wen-hua;  SHAO Zhi-hong;  YE Qing-lin;  ZHONG Wei;  LIN Xiao-qiang;  CHEN Yue-feng;  WANG Xiao-wen
（Department of General Surgery, the 175th Hospital of PLA, Zhangzhou 363000, Fujian，China）
关键词:
海水浸泡; 腹部损伤; 腹腔灌洗装置; 灌洗复温; 炎症反应
Keywords:
seawater immersion;  abdominal injury;  portable peritoneal lavage device;  lavage rewarming;  inflammatory response
分类号:
R656.1;R82
DOI:
10.3969/j.issn.1672-271X.2018.01.003
文献标志码:
A
摘要:
目的 研制一种适合野战条件使用的便携式腹腔灌洗装置，了解运用其灌洗复温对海水浸泡腹腔开放伤犬生命体征、电解质及炎症反应的影响。方法 将10只比格犬随机分为常规即时组和装置即时组，所有犬均经腹部开放伤并海水浸泡处理。常规即时组犬打捞出水后经腹部切口进行常规即时灌洗复温；装置即时组犬打捞出水后用腹腔灌洗装置即时灌洗复温。各组于致伤前、浸泡后以及冲洗后2 h、1 d、3 d和5 d分别观察2组犬生命体征、血清中炎症因子表达水平、组织黏膜的病理变化及显微结构的改变、血浆中Na+、K+、Cl-、乳酸、乳酸脱氢酶等生化指标。结果 常规即时组和装置即时组海水浸泡腹腔开放伤犬血液中肿瘤坏死因子-a（TNF-a）、白介素1b（IL-1b）、干扰素-γ（IFN-γ）、血管内皮生长因子(VEGF)、转化生长因子-b(TGF-b)的含量、炎症细胞浸润程度，组织、器官的损坏随着动物打捞出水时间的延长呈现先升高后降低的趋势，同一时间点组间差异无统计学意义（P>0.05）。腹部开放伤犬经海水浸泡3 h后, 血浆中Na+、K+、Cl-、乳酸、乳酸脱氢酶浓度相对于致伤前明显增高（P<005），Ca2+、HCO-3浓度稍有降低，血浆pH降低；经常规即时灌洗复温和装置即时灌洗复温后，Na+、K+、Cl-浓度相对于浸泡后在1 d、3 d、5 d的检测中逐步降低（P<005），同一时间点组间差异无统计学意义（P>0.05）。结论 采用便携式腹腔灌洗装置即时灌洗复温能达到常规即时灌洗复温同等效果，降低多器官功能衰竭综合征（MODS）的发生，提高救治成功率。
Abstract:
Objective To develop a portable celiac lavage device suitable for field conditions, and to understand its effects on vital signs, electrolytes and inflammatory response of dogs after open abdominal injury and seawater immersion.Methods 10 dogs were divided into two groups randomly and all dogs were treated with open abdominal injury and seawater immersion. Dogs in routine group were salvaged from water then treated with routine real-time irrigation rewarming from the abdominal incision. The dogs in device group were salvaged from water then treated with real-time irrigation rewarming from the abdominal incision by using portable peritoneal lavage device. The levels of vital signs, inflammatory factors expression in serum, histopathological changes, microstructure changes and the concerntration of Na+, K+, Cl-, lactic acid and lactic dehydrogenase in plasma were observed before immension,2 h after immension, 1 day, 3 days and 5 days after lavage, respectively.Results The levels of TNF-α, IL-1β, IFN-γ, VEGF, TGF-bgin the blood, the infiltration of inflammatory cells, the damage of tissues and organs in both groups were increased after immension, and decreased gradully at the later points of time after lavage. There was no significant difference between the two groups at the same time point(P＞0.05). The concentration of Na+, K+, Cl-, lactate and lactate dehydrogenase in the plasma was significantly higher than that before immersion (P＜0.05), and the concentration of Ca2+ and HCO3- and plasma pH decreased slightly(P＜0.05). The concentration of Na+, K+ and Cl- decreased gradually at 1d, 3d and 5d after immersion. There was no significant difference between the two groups at the same time point(P＞0.05).Conclusion Immediate lavage and rewarming using the portable peritoneal lavage device can achieve the same effect of conventional real-time lavage and rewarming. It can reduce the occurrence of MODS and improve the success rate of treatment.

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备注/Memo

备注/Memo:
基金项目：南京军区医药卫生科研基金（ZX21）
更新日期/Last Update: 2018-01-20