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目的 明确低温环境下枪弹伤感染发展的过程和特征。方法 在低温环境下复制犬单侧后肢枪弹伤模型，对伤后９６小时内伤道组织的细菌量及血浆内毒素水平的变化进行动态观察。结果 伤后８小时内，伤道组织菌量增加缓慢，仅达到１０４ｃｆｕ／ｇ，至伤后９６小时菌量未达到１０８ｃｆｕ／ｇ。伤后２小时血浆内毒素水平一过性升高，与伤前相比无显著差异；从伤后８小时开始，血浆内毒素水平变化趋势与伤道组织菌量变化趋势基本一致，呈正相关关系（ｒ＝０．７５９６）。结论 研究结果提示，低温对于枪弹伤后伤道组织菌量的变化影响非常明显，低温环境下枪弹伤感染发展的速度及感染的严重程度均低于常温条件下的枪弹伤；在对该类伤员（包括创伤）进行救治时，应充分考虑到低温对继发感染发生、发展的影响。
Objective To clarify the process and characteristics of bullet wound infection in low temperature environment. Methods The model of unilateral bullet rear-limb gunshot wounds was replicated at low temperature. The changes of bacterial volume and endotoxin level in wound tissues within 96 hours after injury were observed. Results Within 8 hours after injury, the amount of bacteria in wound tissue increased slowly, reaching only 104 cfu / g, and the number of bacteria did not reach 108 cfu / g after 96 hours. At 2 hours after injury, plasma endotoxin level transiently increased, showing no significant difference from the pre-injury level. From the 8th hour after injury, the trend of plasma endotoxin levels showed a consistent trend with that of injured wound tissues, showing a positive correlation (R = 0.7596). Conclusions The results suggest that low temperature has a significant effect on the changes of bacterial flora in the injured wounds after bullet wounding. The speed of bullet wound infection and the severity of the infection under low temperature are lower than that of bullet wounds under normal temperature. (Including trauma) for treatment, should take full account of the impact of hypothermia on the occurrence and development of secondary infection.