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以高、低速投射物致伤犬肢体为实验模型,在观察火器性坐骨神经间接损伤的形态学基础上,对伤道组织内参与伤口愈合的神经递质的第二信使环核苷酸的变化以及胆碱酯酶的活性进行动态观察,探讨上述变化与火器伤伤口愈合的关系。实验发现肢体火器伤时,伤道外坐骨神经结构发生明显损伤,以髓鞘劈裂、轴索裸露、神经微丝减少为特征,高速投射物组明显重于低速投射物伤组。同时伤后6小时至10天,高速组伤道组织cGMP含量以及胆碱酯酶活性均低于低速组。伤后高速组伤道肉芽组织内标志伤口愈合程度的羟脯氨酸含量低于低速组。实验结果提示肢体火器伤时周围神经间接伤与投射物速度有关,周围神经损伤尤其是神经细胞骨架损伤导致神经递质以及胆硷酯酶活性代谢紊乱是影响火器伤伤口愈合的重要因素。因此肢体火器伤时改善周围神经功能,纠正神经递质代谢紊乱是促进伤口愈合的重要措施。
Taking high and low speed projectiles as injuring canine limbs as the experimental model, based on the morphological observation of the indirect injury of firearm sciatic nerve, the changes of the second messenger ring nucleotides involved in wound healing neurotransmitter in the wound tissues and Cholinesterase activity dynamic observation to explore the above changes and firearm wound healing relationship. Experimental found that firearm wounds, the injury outside the sciatic nerve injury occurred in order to myelin splitting axonal bare, characterized by reduced micro-wire neurons, high-speed projectile group was significantly heavier than the low-speed projectile material injury group. At the same time, the content of cGMP and the activity of cholinesterase in the injured tissue of the high-speed group were lower than those of the low-speed group from 6 hours to 10 days after injury. The content of hydroxyproline in wound healing of high-speed injury group was lower than that in low-speed group. The experimental results suggest that the indirect injury of peripheral nerve is related to the projectile velocity in the case of firearm injury of limbs. The peripheral nerve injury, especially the neuronal cytoskeleton injury, leads to the disturbance of neurotransmitter and cholinesterase activity metabolism, which is an important factor affecting the wound healing of firearm wounds. Therefore, limb firearm injury to improve peripheral nerve function, to correct neurotransmitter metabolic disorders is an important measure to promote wound healing.