【摘要】 目的　研究榴弹致胸部创伤的特点和规律 ,为胸部爆炸伤的救治提供依据。方法　用电启动引爆离地面 7m高的榴弹 ,将 36只绵羊布放于距爆心 6～ 4 8m处 ,致伤时测量冲击波超压和破片速度 ,致伤后进行病理解剖观察。结果　胸部破片伤的发生率为 4 4 .4 4 % ,伤后即刻死亡率为 31.2 5% ,伤后 6h时达56.2 5% ,以后增加不明显 ;盲管伤、贯通伤和切线伤的发生率分别为 2 2 .2 2 %、16.67%和 5.56% ;肺冲击伤的发生率为 55.55% ;心脏被直接击中的机率为 5.56% ;肋骨骨折严重 ,胸腔积血多 ,分占胸部创伤动物的 31.2 5%和 87.5%。结论　破片击中胸部的机率高 ,胸壁穿透伤多 ,伤情严重 ,多在伤后 6h以内死亡 ;肺脏不但可被破片直接击中 ,也以更高的比例发生冲击伤。因而救治时不仅要早 ,也要注意检查和处理肺冲击伤。更多还原

【Abstract】 Objective To study the features and rules of thoracic trauma resulting from high explosive shell in order to obtain the principles and base for the treatment of thoracic explosive trauma. Methods Thirty six sheep were distributed at the distances of 6 to 48 m from the explosive center and the shell was exploded electrically at 7 m over the earth. The fragment velocity and shock wave pressure were measured and pathological damages were observed after the explosion. Results The rate of thoracic fragment trauma was 44.44%. The immediate morality was 31.25%, morality 6 h after the explosion was 56.25% and it kept later on. The incidence rates of blind, penetrating and tangential wounds were 22.22%, 16.67% and 5.56% respectively, while that of lung shock trauma was 55.55%. The heart was hit with a rate of 5.56%. Severe rib fracture and hemotocele in chest cavity were most common and covered almost 31.25% and 87.5% in all animals with thoracic trauma. Conclusion High rate of fragment traumata, more chest wall penetrating wounds, severe rib fracture and death 6 h after explosion happen commonly in thoracic trauma resulting from high explosive shell. The lungs are not only hit by fragments but also damaged by shock wave. So, the first care should be performed as early as possible and examine and manage the lung blast injury.更多还原