摘要
本文采用5.56和7.62mm两种弹头射击肥皂和狗双后肢。观察其瞬时空腔和压力波对外周神经的影响。实验表明,神经移位和神经牵拉率与瞬时空腔容积,压力峰值及能量吸收之间呈指数回归关系。神经损伤程度取决于瞬时空腔大小和能量吸收的多寡。5.56mm弹头能量吸收量为40.67kg·m,是7.62mm弹头的2.5倍,最大压力峰值是7.62mm弹头的1.8倍。因此,5.56mm弹头所致神经损伤较7.62mm弹头严重。组织学检查可见神经纤维断裂,束膜出血,轴索变形,线粒体肿胀,髓鞘与轴索膜分离。脊髓诱发电位检查,5.56mm弹头致伤组电位潜伏期延长,波幅下降明显。结果提示,高速投射物间接神经损伤是不完全性的,在这种火器性间接神经损伤治疗中,早期进行手术探查,清除肌间及筋膜间血肿缓解神经内压,促进微循环恢复是提高治愈率及减少后肢并发症的关键。
The effects of the temporary cavities and pressure waves of peripheral nerves were studied following 5.56mm and 7.62mm bullets shooting the soap block and both thighs of dogs. The studies indicated that there was an exponential regression correlation among the displacement and stretching ratio of nerves and temporary cavity, the maximum of pressure peak(MPP), and energy absorption (EA). The degree of nervous injuries depended on the temporary cavity volume and amounts of EA. The amounts of EA of 5.56mm bullets were 40.67kg·m,2.5 times as much that of 7.62mm bullets.MPP of 5.56mm bullets was 1.8 times as of 7.62mm.This suggested that the nerve injuries caused by 5.56mm bullets were more severe than of 7.62mm bullets. Pathological examination showed that the microstructure of nerves was damaged though the microstructure unchanged. Fibre-broken-up, bleeding in perineurium, deformation of axon, mitochondria swelling and axon membrane dividing from its myelin sheath could be seen. In 5.56 bullet wounding group the potential latency was prolonged and the amplitude decreased remarkedly. This indicated that the nerves were only damaged partially. In early management it is important to release intraneural pressure, remove the hematoma in the fascia to recover microcirculation.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
1990年第4期322-325,共4页
Journal of Third Military Medical University
关键词
火器伤
四肢
周围神经伤
wounds and injuries
peripheral nerves/IN
extremities/IN
