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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:

41

期数:

2019年04期

页码:

115-118

栏目:

基础研究

出版日期:

2019-08-15

文章信息/Info

Title:

Experimental study of radiofrequency coagulation in the treatment of liver injury caused by different factors combined with seawater immersion

文章编号:

1002-2600(2019)04-0115-04

作者:

江哲龙 沈佳佳 张小进 程 远 潘 凡 江 艺 吕立志¹

中国人民解放军联勤保障部队第900医院肝胆外科(福州 350025)

Author(s):

JIANG Zhelong;  SHEN Jiajia; ZHANG Xiaojin;  CHENG Yuan; PAN Fan; JIANG Yi

Department of Hepatobiliary Surgery, Chinese Peoples Liberation Army Joint Logistics Support Force No.900 Hospital, Fuzhou,Fujian 350025,China

关键词:

肝;  火器伤贯通伤;  刀刺伤;  射频凝固

Keywords:

liver;  firearm penetrating injury;  knife stabbing;  radiofrequency coagulation

分类号:

R657.3

文献标志码:

B

摘要:

目的 研究肝脏刀刺伤、火器贯通伤合并海水浸泡后射频凝固治疗效果分析及伤 情特点。方法 选用20条成年雄性比格犬作为研究对象,根据不同的致伤因素分为火器伤组10 只,刀刺伤组10只,且致伤后海水浸泡,采用射频凝固技术进行肝脏止血。检测致伤前、术后 第3、7、14天的血常规、血生化指标变化,记录犬生存时间,统计存活率,体质量,并发症的情 况。 结果:两组20条犬均存活至术后第14天,存活率为100%。火器贯通伤组白细胞计数在术 后第7、14天较刀刺伤明显升高(P=0.004、P=0.000)。火器贯通伤组 血红蛋白浓度在术后第3天较刀刺伤组降低明显(P=0.35)。两组血小板术前、术后无 明显改变,其余观测点指标两组均无明显改变。两组ALT、AST、ALB在各观测点比较无明显改 变。火器伤仅2只切口愈合良好,8只存在不同程度的切口感染,占80%,刀刺伤有4只切口感染 、6只愈合良好,虽然两组无明显改变; 但在术后14天剖腹探查,火器伤组10只(100%)均有不 同程度的腹腔感染,刀刺伤有7只(70%)腹腔感染、3只仅有腹腔少许粘连,经比较的差异有统 计学意义(P=0.025)。结论 射频消融凝固技术在肝脏的火器伤、刀刺伤救治中均取 得积极有效的治疗作用; 火器伤合并海水浸泡经射频治疗后腹腔较刀刺伤更容易出现感染, 伤情更为严重、复杂。

Abstract:

Objective To investigate the effect of radiofrequency coagulation therapy on the liver after knife stabbing, firearm penetrating injury combined with seawater immersion.Methods Twenty adult male beagle dogs were selected as subjects, grouping according to different injury factors.Ten in firearm penetrating injury group and 10 in knife stab wound group were immersed in seawater.Radiofrequency coagulation for liver hemostasis after injury.Detection of changes in blood routine indicators and blood biochemical parameters before injury, the 3rd,7th and 14th days after operation.The survival time, survival rate, body weight and complications were recorded.Results Twenty dogs in both groups survived to the 14th day after operation, with a survival rate of 100%.The leucocyte count in firearm wound group was significantly higher than that in knife stab wound group on the 7th and 14th day after operation,with statistical difference(P=0.004,P=0.000).The hemoglobin concentration in firearm wound group was significantly lower than that in knife stab wound group on the 3rd day after operation,with statistical difference (P=0.35).There was no statistical difference in platelet index between the two groups before and after operation, and there was no statistical difference in other observation points between them.There was no significant difference in AST, ALT and ALB between the two groups.In firearm wound group, only two dogs healed well, eight dogs had different degrees of wound infection, accounting for 80%.In knife stab wound group,four dogs had wound infection and 6 dogs healed well.There was no statistical difference between the two groups.The dogs in the two groups were examined by laparotomy 14 days after operation.Ten dogs in the firearm wound group had abdominal infection in varying degrees, seven dogs in the knife stab wound group had abdominal infection and three dogs had only a little abdominal adhesion.There was statistical difference between the two groups(P=0.025).Conclusion Radiofrequency ablation hemostasis technology has achieved positive and effective therapeutic effect in the treatment of firearm injury and knife stab injury of liver.After radiofrequency treatment, the abdominal cavity of firearm wound combined with seawater immersion is more susceptible to infection than that of knife stab wound, and the wound is more serious and complex.

备注/Memo

备注/Memo:

基金项目:全军面上课题(CNJ15J002) 1 通信作者,Email:913362374@qq.com

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更新日期/Last Update: 2019-08-15