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目的:破片和冲击波是爆炸性武器的主要致伤因素,探讨破片与冲击波复合伤的伤情特点及其对病程经过的影响。方法:实验于2003-11在西北地区某戈壁滩完成。山羊71只,用装药量200kg的战斗部进行静爆,观察现场至伤后18h动物的活存情况,形态学改变以及破片与冲击波复合伤伤情特点及其对病程经过的影响。结果:现场死亡48例,伤后6～18h死亡7例,死亡率为77.46%(55/71),形态学改变主要表现为躯体全身性或部分毁损,体腔破裂,肢体离断骨折,心、肺、肝、脾、肾、胃肠道等不同程度的毁损、破裂和出血。破片与冲击波复合伤的发生率为74.65%(53/71),平均每只动物有8.9处伤,多发伤、胸腹联合伤和烧伤的发生率分别为96.23%,24.53%和11.32%,死亡率为96.23%(51/53)。结论:破片与冲击波复合伤具有发生率高,伤型伤类复杂,伤情重和死亡率高等特点。易漏诊、误诊和发生内脏并发症以及处理措施不当是病程经过中影响康复的主要因素。
OBJECTIVE: Fragment and shock wave are the main causative factors of explosive weapons, and explore the characteristics of injury and its effect on the course of disease after the combined injury of fragments and shock wave. Methods: Experiments were performed on a Gobi Desert in Northwest China from 2003-11. 71 goats were killed by the warhead with a charge of 200kg. The survival of the animals at 18h after the injury was observed, the morphological changes and the characteristics of the combined injuries of the fragments and the shock wave and their effects on the course of the disease were observed. Results: There were 48 deaths on site and 7 deaths at 6 to 18 hours after injury. The mortality rate was 77.46% (55/71). The main morphological changes were systemic or partial destruction of body, broken body cavity, fractured limbs, Lung, liver, spleen, kidney, gastrointestinal tract, such as varying degrees of damage, rupture and bleeding. The incidence rate of combined injury of fragment and shock wave was 74.65% (53/71), with an average of 8.9 injuries per animal, multiple injuries, combined injuries of thoracoabdominal and abdomen, and the incidence of burns were 96.23%, 24.53% and 11.32%, respectively The rate was 96.23% (51/53). Conclusion: Fragmentary and shock wave composite wounds have the characteristics of high incidence, complicated wound injuries, heavy injuries and high mortality. Misdiagnosis and misdiagnosis and the occurrence of visceral complications and improper treatment are the main factors that affect the course of rehabilitation.