海水中肢體火器傷傷后傷道細(xì)菌種類分析

摘要： 目的:觀察海水中犬肢體火器傷后傷道早期細(xì)菌變化,結(jié)合文獻(xiàn)探討初期外科處理。方法:將17只普通級畢格犬分為海水中致傷組(n=14)和地面致傷組(n=3)。海水組于海水中槍傷后救出,傷后0、6、12、24 h進(jìn)行傷道細(xì)菌檢測和藥敏試驗(yàn)。地面組為觀察對照。結(jié)果:傷肢腫脹、組織壞死和動物死亡時間,海水組均較地面組嚴(yán)重和提前;海水組革蘭氏陽性球菌和革蘭氏陰性桿菌較多,以鏈球菌、金黃色葡萄球菌、大腸桿菌為主的混合感染,頭孢菌素、氨基糖甙類對多種細(xì)菌敏感。結(jié)論:海水中火器傷后細(xì)菌數(shù)量種類多,感染時間提前且嚴(yán)重,處理更應(yīng)強(qiáng)調(diào)盡早徹底清創(chuàng)、早期使用廣譜抗生素。
Objective:To investigate the early-stage bacteria change and surgical treatment of the wound tracts of the limbs in dogs undergoing gunshot in seawater.Methods: Fourteen conventional Beagles models with gunshot wound in seawater were established,and another 3 dogs receiving gunshot wound without seawater immersion served as control.After the dogs undergoing gunshot wound in seawater were extricated,germ detection and medicament experimentation were performed at 0,4,6,8,12 and 24h respectively.Results: Compared with on land,more severe swelling and tissue necrosis around the wound were observed and a shorter pathological period was found after gunshot in seawater,with more Gram-positive cocci and Gram-negative bacilli.The mixed infection mainly resulted from streptococcus,staphylococcus aureus and colon bacillus.Conclusion: Severe bacterial infection may develop after gunshot wound in seawater.Broad-spectrum antibiotics and complete debridement should be recommended in early stage.