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Background and purpose: in modern war and times of peace, in a confined space explosion injury incidence rate. Because the brain is not blast the target organ, the treatment focuses on the surface of the wound in the lungs, gastrointestinal tract, hearing the impact of the target organ injury. According to the literature, the explosion led to a higher incidence of traumatic brain injury, but the impact of traumatic brain injury treatment is often overlooked. Brain blast injury in a confined space small parts for the injured brain injury is difficult to accurately diagnose and rescue. The purpose of this topic is to establish a traumatic brain injury model accurately reflects the explosion in the confined space, to study the early injury characteristics and rules, combined with shock wave pressure test to explore brain injury mechanisms for confined space within the brain explosion injuries early prevention, rapid diagnosis provide a theoretical basis. Method: 1. Establish cabin explosion damage model: SD adult male rats to 56, were randomly divided into the cabin 400mg TNT equivalent fragments point explosion source explosion group (n = 48) and normal control group in the pre-injury 8. Explosion group in the explosion injured model simulation of armored personnel carriers were also determined and cabin 200 mg, 400 mg, 600mgTNT equivalence point explosion source blast physical parameters observed after injury, general, rat mortality, brain, lung pathological changes of the heart and brain water content changes. 2 cabin brain blast injury injury characteristics: 218 SD adult male rats, were randomly divided into the cabin 200mg, 400mg, 600mg group and extravehicular 400mg, 600mg group and the normal pre-injury control group. Cabin group injured by the same model with the establishment of, extravehicular group animals in the open explosion injured animal away from the blast center cabin group. Respectively rats General 1,3,6,12,24,72 hours after the injury, mortality, gross anatomy, plasma S100B protein was detected by ELISA, neuron-specific enolase, brain natriuretic peptide, record 6 hours after injury heart rate, mean arterial pressure, left ventricular systolic pressure, left ventricular pressure maximum rate of change detected by immunohistochemistry 24 hours after injury neuronal apoptosis positive rate measured brain water content, wet and dry weight method, combined with Pathological observation of morphological changes of brain tissue in the light microscope. Results: 1 cabin explosion damage model: after the explosion can be observed in rats breathing deep, slow, then gradually speed up, no death, in 3 hours awake, the free exercise, eating, water, but lower than the pre-injury normal control group unresponsive. Cerebral subarachnoid hemorrhage, pulmonary hemorrhage. Explosion rats wound brain water content increased gradually over time, 6 hours and reached the peak, still higher than the normal 72 hours. The experimental method can copy the model of of explosive brain injury for Research cabin brain. 2 cabin brain blast injury injury characteristics: 1 hour after the explosion in the cabin group hurt to see the cerebral cortex and vascular congestion, subarachnoid hemorrhage and cerebral edema changes; pulmonary parenchymal damage, bleeding obvious, and explosion the equivalent positive correlation; microscope, myocardial fiber breakage; plasma S100B protein, neuron-specific enolase, brain natriuretic peptide after injury over time development were significantly increased law; 24h neuronal apoptosis was significantly increased after injury; injured by animals heart rate, mean arterial pressure, left ventricular systolic pressure, left ventricular pressure maximum rate of change, there are different degrees of change. Cabin brain blast injury injury injury explosives equivalent positive correlation, compared with the extravehicular the same equivalent explosives injury heavier. Conclusions: 1. Establish a model of stability in a confined space explosion traumatic brain injury in rats. 2 confined space the shockwave more open space waveform of the shock wave and the shock wave parameters were significantly different. Confined space and open space blast can lead to the obvious traumatic brain injury. (4) the shockwave more open space within the confined space shock wave significantly increased rat impact injury of brain damage, cerebral edema, increased neuronal apoptosis positive rate, significantly increase the blast injury injury, and injury and explosives equivalent positively correlated. Confined space explosion traumatic brain injury characteristics can be summarized as: (1) cerebral edema occurs early, closely related to the duration of the edema and explosion equivalent; ② the surface of the cerebral hemisphere extensive cerebral subarachnoid hemorrhage, injuries skull base hemorrhage . ③ neuronal apoptosis was significantly increased; (4) brain damage markers was significantly higher. 6 blast injury-prone injury is more common, is the most obvious the shock wave target organ lung tissue, cardiac function also have varying degrees of change. 7 should be strengthened the blast injury protection for the brain to focus on the early treatment.
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