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Previous studies have shown that vagus nerve stimulation can improve the prognosis of trau-matic brain injury. The aim of this study was to elucidate the mechanism of the neuroprotective effects of vagus nerve stimulation in rabbits with brain explosive injury. Rabbits with brain ex-plosive injury received continuous stimulation (10 V, 5 Hz, 5 ms, 20 minutes) of the right cervical vagus nerve. Tumor necrosis factor-α, interleukin-1βand interleukin-10 concentrations were detected in serum and brain tissues, and water content in brain tissues was measured. Results showed that vagus nerve stimulation could reduce the degree of brain edema, decrease tumor necrosis factor-αand interleukin-1βconcentrations, and increase interleukin-10 concentration after brain explosive injury in rabbits. These data suggest that vagus nerve stimulation may exert neuroprotective effects against explosive injury via regulating the expression of tumor necrosis factor-α, interleukin-1βand interleukin-10 in the serum and brain tissue.
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1例火器爆炸伤致急性特重型开放性颅脑损伤的护理
1病例介绍病人,男,39岁,因酒后燃放烟火炸伤头部致意识丧失伴呕吐5 h入院,查体:右额面部呈星状开放性火器爆炸伤,皮肤大面积损毁,伤处有脑组织溢出伴有活动性出血,量约800 mL左右.病人呈昏迷状态,双侧瞳孔不等大,右侧5.0 mm,对光反射迟钝,左侧约3.0 mm,直接光反射存在,间接光反射消失,呼吸道有大量呕吐物堵塞,颈部有皮下气肿,血压75/40 mmHg(1 mmHg=0.133 kPa),血氧饱和度67%,大量补液进行抗休克治疗,急诊行气管切开术,加大氧流量.
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颌面部爆炸伤后外形修复实验研究
Objective To study the characteristics and the way of reconstruction in maxillofacial explosive wound. Methods 30 dogs were randomly divided into 6 groups and the maxillofacial region were wounded by smoothbore barrels combined with detonators. Histological changes of soft tissue at different distance from wound track were observed after injury. At 72h post injury, 5 dogs in one group were re debrided and reconstructed. Results At 72h after wound, the soft tissue injury was the most serious. Muscles at 0~ 0.8 cm distant to the wound track were completely necrotized. The vibration area spread beyond 1.6 cm. The wounds were well healed. Conclusions The explosive injury of maxillofacial region was characterized by wide range of injury and heavily contamination. The reconstruction of soft tissue defect by vascularized gracilis flaps was effective.