抗菌药物陶瓷缓释体在延迟高原弹片伤外科处理中的应用
弹片伤；抗菌药物缓释体；高原,,弹片伤；抗菌药物缓释体；高原,关键词：弹片伤；抗菌药物缓释体；高原,材料与方法,结果,讨论,参考文献：
摘要： 目的 探讨延长高原弹片伤伤员初期外科处理时间的措施。方法 在海拔3658m的拉萨地区，以滑膛枪发射1.03g的钢球击中猪后肢股中部，避免伤及股骨、大血管。实验猪随机分为缓释体组和口服对照组。伤后1小时在缓释体组实验猪伤道内放置生物陶瓷药物缓释体，内盛装原药环丙沙星25mg，替硝唑60mg，包扎伤道，24小时后更换敷料，48小时后取出缓释体，清创后闭合伤道，伤后第9天观察伤道愈合情况。于伤后1、24、48小时测定伤道组织的细菌数，并做药敏试验，于伤后24、48小时切取伤道组织，测定琥珀酸脱氢酶(SDH)、三磷酸腺苷(ATP)酶活性。对照组实验猪伤后口服环丙沙星和替硝唑，余处理同缓释体组。结果 伤后24、48小时缓释体组伤道细菌数为104/g湿组织，伤道组织SDH、ATP酶活性高于对照组，伤后48小时清创后，伤道愈合良好。口服对照组伤后48小时伤道感染明显，伤道细菌数达108/g湿组织。结论在高原弹片伤伤道内放置抗菌药物陶瓷缓释体，可防止感染，推迟清创至伤后48小时。关键词：弹片伤；抗菌药物缓释体；高原
Application of ceramic antibiotic drugs carriers in the treatment of delayed fragment wounds at high altitude
LAI Xinan，CHENG Zhixiong，LI Suzhi，et al.
( Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,China)
Abstract: Objective To explore the management of delayed fragment wounds at high altitude.Methods The pigs hind legs were hit by steel balls(weight 1.03g) using a smooth gun,and the damage of major vessels and femur was avoided.The wounded pigs were randomly arranged into the ceramic carrier group and the control group.The ceramic carriers,which carried cinrofloxacin and tinidazole were placed into the wound tracks of the ceramic carrier group 1h after wounds.The dressings were changed 24h after wounds.The carriers were removed from the wound tracks,dead tissue of wound track excised and the wound tracks were irrigated,drained out,and then sutured 48h after wounds.The wound healing was observed 9 days after wounds.The bacteria number at the wound track and the sensitivity to antibiotic were assayed 1,24,48h after wounds.The tissue samples of the wound tracks were excised,activities of succinate dehydrogenase(SDH) and ATPase were assayed 24,48h after wounds.These antibiotic agents,carried by biological ceramic carriers were orally administered to the pigs of control group and other treatments were coincident with those mentioned in the ceramic carrier group.Results The bacterial number in the wound track of the ceramic carrier group was 104/g wet tissue,and activities of SDH,ATPase were higher than those in the control group 24,48h after wounds.The wound track of the ceramic carrier group,in which debridment was carried out 48h after wounds,was healing well 9d after wounds.Infection of the wound track in the control group was obvious and bacterial number was 108/g wet tissue 48h after wounds.Conclusion The results suggest that placement of ceramic carriers containing cinrofloxacin and tinidazole to the delayed fragment wound track may prevent wounded tissue infection,and the debridment can be delayed 48h after wounds at high altitude. ......
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