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水下爆炸致水面泅渡战位比格犬脑和肺的损伤特点
李彦腾,程岗,魏铂沅,王淑为,吕文英,张雷鸣,董超,张剑宁*
0
(解放军总医院第一医学中心神经外科医学部, 北京 100853
*通信作者)
摘要:
目的 研究水下爆炸引起水面泅渡战位比格犬脑和肺的损伤情况。方法 20只健康比格犬随机分为4个实验组(距爆源5、8、11和15 m)和1个对照组(n=4)。利用1 kg 2,4,6-三硝基甲苯(TNT)裸药在水下2 m实施爆炸对水中漂浮比格犬进行致伤,采用水下及颅内压力传感器和高速摄像机记录爆炸致伤的过程。爆炸后3 h内对存活的比格犬行头部和胸部CT检查及头部MRI检查。爆炸后24 h取脑和肺标本,观察颅脑和胸、肺大体损伤情况,并通过H-E染色和TUNEL染色观察脑和肺组织病理学变化及细胞凋亡情况。结果 压力传感器和高速摄像机观察到水下爆炸的致伤过程包括冲击波作用和气泡作用2个阶段。5 m、8 m、11 m和15 m组比格犬分别死亡4、3、1、0只。头部CT和MRI检查示实验组比格犬脑组织没有明显损伤,胸部CT检查示有肺内出血、气胸、血胸或胸腔积液等表现。H-E染色结果示实验组比格犬脑组织无明显变化,而肺组织肺泡破裂,肺泡腔内有大量红细胞,肺间质内有大量炎症细胞浸润。TUNEL染色仅见海马区少量细胞呈阳性表现,而肺组织肺泡上皮细胞和间质细胞呈现广泛的凋亡坏死趋势。结论 水下爆炸引起水面泅渡战位比格犬的损伤主要为肺爆震伤,脑组织损伤相对轻微。
关键词:  水下爆炸  爆震伤  脑损伤  肺损伤
DOI:10.16781/j.0258-879x.2021.07.0755
投稿时间:2020-07-01修订日期:2020-12-18
基金项目:全军后勤科研重大项目(AHJ14J001),国家自然科学基金(81372128).
Characteristics of brain and lung injuries of beagles in swimming battle position caused by underwater explosion
LI Yan-teng,CHENG Gang,WEI Bo-yuan,WANG Shu-wei,Lü Wen-ying,ZHANG Lei-ming,DONG Chao,ZHANG Jian-ning*
(Department of Neurosurgery, the First Medical Center, PLA General Hospital, Beijing 100853, China
*Corresponding author)
Abstract:
Objective To study the damage of underwater explosion to the brain and lung of beagles in the swimming battle position. Methods Twenty healthy beagles were evenly randomized into 4 experimental groups (5 m, 8 m, 11 m or 15 m away from the explosion source) and a control group (n=4). Beagles in water were subjected to the explosion of 1 kg 2,4,6-trinitrotoluene (TNT) equivalent bare explosive 2 m underwater. Underwater and intracranial pressure sensors and high-speed camera were used to record the process of explosion injury. Computed tomography (CT) scans of the head and chest, as well as magnetic resonance imaging (MRI) scans of head were performed 3 h after the explosion. Brain and lung specimens were taken 24 h after the explosion, and injuries of them were observed. Hematoxylin-eosin (H-E) staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining were performed afterwards to observe the histopathological changes and apoptosis of brain and lung tissues. Results The records of pressure sensors and high-speed camera showed the injury process of underwater explosion included 2 stages:blast wave and bubble pulsation. There were 4, 3, 1 and 0 beagles died in 5 m, 8 m, 11 m and 15 m groups, respectively. The head CT and MRI showed that there was no obvious brain injury in the experimental groups, while the chest CT showed that there were intrapulmonary hemorrhage, pneumothorax, hemothorax or pleural effusion. H-E staining showed that there were no obvious changes in the brain tissue of beagles in the experimental groups, but the alveoli were ruptured, and there were a large number of red blood cells in the alveolar cavity, and many inflammatory cells infiltrated in the lung interstitial. TUNEL staining showed only a few positive cells in the hippocampus, while the alveolar epithelial cells and interstitial cells in the lung showed a trend of extensive apoptosis and necrosis. Conclusion The main injury caused by underwater explosion to beagles in swimming battle position is lung blast injury, while the brain tissue injury is relatively slight.
Key words:  underwater explosion  blast injuries  brain injuries  lung injuries