引言爆炸伤害在现代社会中经常发生,由于在密闭空间中的恐怖袭击,特别是在城市环境中,室内,在车辆中,导致重大损害。因此,重要的是要关注狭窄空间中的爆炸伤害,而不是传统的露天实验。材料和方法我们使用了2017年在室内建立的空气驱动冲击波发生器(鼓风管),并进行了基础研究,以潜在地挽救爆炸伤患者的生命。在全身麻醉下,猪分为有防弹衣(BA)和无BA组。将猪固定在测量室中,其背部胸部直接暴露于冲击波。驱动压力设定为3.0MPa以实现约50%的死亡率。产生的冲击波直接施加到猪身上。在心脏骤停和生存率方面进行了组间比较,以及呼吸暂停,心动过缓,低血压,这是爆炸肺的三合会。进行尸体解剖以确认器官损伤的程度。使用Fisher精确检验进行统计分析,统计学意义为p<0.05。根据国防医学院附属医院动物伦理委员会审查和批准的方案(批准号19041)进行动物实验。结果8头猪被分配到BA组,7头猪被分配到非BA组。在非BA组中,在7例中的4例中观察到呼吸暂停,其中三人导致死亡。BA组中的八头猪都没有呼吸停止;值得注意的是,都活了下来。在每组的一些猪中观察到低血压;然而,两组均无心动过缓病例.统计分析表明,佩戴BA可显着降低呼吸和心脏骤停的发生率(p=0.026),但未降低生存率(p=0.077)。其他生命体征无明显差异。结论佩戴具有足够颈部和胸部保护的BA可以降低死亡率,并且可以有效地减少针对冲击波暴露的心脏和呼吸骤停。冲击波损伤的死亡率似乎与呼吸停止有关,避免呼吸停止可能导致生存。
Introduction Blast injuries in modern society often occur owing to terrorist attacks in confined spaces, particularly in urban settings, indoors, and in vehicles, leading to significant damage. Therefore, it is important to focus on blast injuries in confined spaces rather than in conventional open-field experiments. Materials and methods We used an air-driven shock wave generator (blast tube) established indoors in 2017 and conducted basic research to potentially save the lives of patients with blast injuries. Under general anesthesia, pigs were divided into with body armor (BA) and without BA groups. The pigs were fixed in the measurement chamber with their dorsal chest directly exposed to the shock wave. The driving pressure was set at 3.0 MPa to achieve a mortality rate of approximately 50%. A generated shock wave was directly applied to the pigs. Comparisons were made between the groups with respect to cardiac arrest and survival, as well as apnea, bradycardia, and hypotension, which are the triad of blast lung. Autopsies were performed to confirm the extent of the organ damage. Statistical analysis was performed using Fisher\'s exact test, and statistical significance was set at p<0.05. The animal experimentation was conducted according to the protocol reviewed and approved by the Animal Ethics Committee of the National Defense Medical College Hospital (approval number 19041). Results Eight pigs were assigned to the BA group and seven pigs to the non-BA group. In the non-BA group, apnea was observed in four of seven cases, three of which resulted in death. None of the eight pigs in the BA group had respiratory arrest; notably, all survived. Hypotension was observed in some pigs in each group; however, there were no cases of bradycardia in either group. Statistical analysis showed that wearing BA significantly reduced the occurrence of respiratory and cardiac arrest (p=0.026) but not survival (p=0.077). No significant differences were found in other vital signs. Conclusions Wearing BA with adequate neck and chest protection reduced mortality and it was effective to reduce cardiac and respiratory arrest against shock wave exposure. Mortality from shock wave injury appears to be associated with respiratory arrest, and the avoidance of respiratory arrest may lead to survival.