[1]苏正林,许民辉,赖西南,等.枪弹射击致防弹衣后长白猪远达脑组织损伤特点及其机制[J].第三军医大学学报,2011,33(19):1995-1999.
 Su Zhenglin,Xu Minhui,Lai Xinan,et al.Characteristics and mechanism of behind armour blunt trauma in Landrace brain[J].J Third Mil Med Univ,2011,33(19):1995-1999.
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枪弹射击致防弹衣后长白猪远达脑组织损伤特点及其机制(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
33卷
期数:
2011年第19期
页码:
1995-1999
栏目:
论著
出版日期:
2011-10-15

文章信息/Info

Title:
Characteristics and mechanism of behind armour blunt trauma in Landrace brain
作者:
苏正林许民辉赖西南张波黄艺峰王丽丽
第三军医大学大坪医院野战外科研究所:神经外科,第六研究室,创伤、烧伤与复合伤国家重点实验室
Author(s):
Su Zhenglin Xu Minhui Lai Xinan Zhang BoHuang Yifeng Wang Lili
Department of Neurosurgery, State Key Laborary of Trauma, Burns and Combined Injury, Department 6 Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China
关键词:
防弹衣后钝性损伤脑损伤脑电图生物力学
Keywords:
behind armor blunt trauma (BABT)brain injuryelectroencephalogram(EEG)biomechanics
分类号:
R826.5; R651.15
文献标志码:
A
摘要:
目的     观察防弹衣后远达脑组织的损伤特点及探讨损伤的生物力学机制。     方法       18只雄性长白猪分成假致伤组(n=4),子弹速度910 m/s组(n=6),740 m/s组(n=4)和590 m/s组(n=4)。致伤模型为麻醉后长白猪右侧卧位,胸前包裹外层为防护等级NIJⅢ级陶瓷硬式防弹衣,内层为警用Ⅱ级超高分子聚乙烯软式防弹衣,小口径弹道枪以25 m 射距、3种不同弹速瞄准左锁骨中线4、5肋间(心脏窗)射击,假致伤组行空爆弹射击。持续监测致伤前后脑电图、心电图、有创动脉血压、心率、呼吸变化。取伤前,伤后1、2、3 h血浆进行脑损伤标志物检测,伤前及伤后3 h脑脊液进行特异性脑损伤蛋白检测。伤后3 h深麻醉后放血处死动物,取脑组织进行病理检查。另取4只雄性长白猪行生物力学测试,在上述模型基础上于弹着点心前区皮下、心包腔、左侧胸腔、左侧颈总动脉及颅内布放压力传感器,心前区锁骨中线第6肋骨布放加速度传感器及力传感器,测试命中时各部位生物力学参数及持续时间,进行分析。     结果      3种不同速度组致伤后2 min内脑电图低频Delta、Theta波定量分析频谱强度幅值与致伤前比较明显降低(P<0.05),降幅约10%,伤后5 min 后回升恢复到伤前水平,3种速度组间无显著差异(P>0.05)。伤后3 h光镜下尼氏染色海马存在急性损伤改变,910 m/s组海马神经元胞体萎缩,细胞核大小不等;740 m/s组神经元胞体萎缩,细胞核偏位;590 m/s组神经元轻度肿胀,损伤分级910 m/s组>740 m/s组>590 m/s组>假致伤组。3种速度子弹击中心前区防弹衣时心包腔、胸腔、颈内动脉及颅内压力瞬间急速上升,590 m/s组(23.32±4.41)kPa,740 m/s组(45.52±27.38)kPa,910 m/s组(88.27±8.81)kPa,两两比较3组压力有显著差异(P<0.01)。在外层NIJⅢ内层为警用Ⅱ级防护下,随着子弹速度的增加,长白猪出现中枢神经脑电抑制,在海马区出现中枢神经元变性、脱髓鞘改变,可能产生早期症状及中晚期效应。生物力学检测提示在硬质防弹衣防护下,子弹高速打击长白猪心前区防弹板,使动物产生了较小的位移,瞬间子弹动能由极高降为0。     结论     子弹制动所释放出的能量通过防弹衣的变形传递给生物体,通过对空腔脏器(肺脏、心脏)冲击及通过骨性传递可以到达远端中枢神经,可能是产生远达损伤的原因。
Abstract:
Objective       To study the characteristics of behind armor blunt trauma extending to the brain and to investigate the biomechanics mechanism of the remote injury.      Methods       Eighteen male Landraces were randomly divided into a sham injury group (n=4), a bullet velocity 910 m/s group (n=6), a 740 m/s group (n=4) and a 590 m/s group (n=4). The injury model was anesthetized Landrace in right lateral position and wrapped in a two-layer bullet-proof vest. The outer layer was ceramic hard armor with NIJ III protection grade. The inner layer was police grade II ultra-high molecular polyethylene soft body armor. Caliber 5.8 mm ballistic guns were fired at 25 m range and three different projectile velocities, aimed at the left midclavicular line 4, 5 intercostal (heart window). Air bomb shooting was applied to sham injury group. EEG, ECG, invasive arterial blood pressure, heart rate and respiratory changes before and after injury were continuously monitored. Plasma was collected at 1, 2 and 3 h before and after injury to detect markers of brain injury. Lumbar puncture was taken at 3 h before and after injury to test specific brain injury protein in cerebrospinal fluid. In 3 h after injury the animals were deep anesthetized and bled to death. Their brain blocks were collected for toluidine blue staining and electron microscopy. The other 4 Landrace pigs were used for biomechanical testing. On the basis of the above model pressure sensors were placed in the subcutaneous layer of precordium at the point of impact, pericardial cavity, left chest, left common carotid artery and cranial cavity. Acceleration sensors and force sensors were placed in the sixth rib at precordial midclavicular line. When the target was hit, each part’s biomechanical parameters and duration were recorded and analyzed.      Results      In the 3 groups of different speed, spectrum intensity of low-frequency EEG Delta and Theta wave within 2 minutes after injury was significantly lower than that before injury (P<0.05), and the decline was about 10%. In 5 min after injury the amplitude was restored to pre-injury level. There was no significant difference among 3 speed groups (P>0.05). Three hours after injury, acute injury alterations were found in Nissl stained hippocampal under light microscope. The 910 m/s group had hippocampal neurons atrophy and varying sizes of nuclei; the 740 m/s group had neurons atrophy and nucleus deviation; the 590 m/s group had mild neuron swelling, injury scale 910 m/s group >740 m/s group >590 m/s group >sham injury group. When bullets hit precordial vest at three different speed, pressures in pericardial cavity, chest cavity, internal carotid artery and cranial cavity instantly surged, to 23.32±4.41 kPa in 590 m/s group, 45.52±27.38 kPa in 740 m/s group, and 88.27±8.81 kPa in 910 m/s group. Each group’s pressure was significantly different from that of the other two groups (P<0.01).      Conclusion       Under the protection of NIJ III grade outer layer and police II grade inner layer, as the bullet speed increases, the Landrace has central nervous EEG suppression, central neuron degeneration and demyelination in hippocampus, which may produce early symptoms and late effects. Biomechanical testing suggests that under hard armor protection, high-speed bullet hitting Landrace precordial bulletproof plate causes a small displacement of the animal and kinetic energy of the bullet instantly decreased from extremely high to 0. The energy passes to the organism through body armor deformation. It could reach remote central nervous system through pulmonary hollow organs, heart impact and bone transfer, and this may be the reason for remote injury.

参考文献/References:

苏正林, 许民辉, 赖西南, 等. 枪弹射击致防弹衣后长白猪远达脑组织损伤特点及其机制[J].第三军医大学学报,2011,33(19):1995-1999.

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更新日期/Last Update: 2011-10-12