Abstract: Objective To establish an animal model of abdominal bullet wound, and study the application of rapid anastomotic magnetic ring in animal models of abdominal bullet wounds, providing ideal animal modeling for clinical and basic research of field surgery. Method To establish the animal model of abdominal bullet wound, right lower abdomen of Bama miniature pigs were injured with a domestic 95-type assault rifle. Qualified animal models were randomly divided into magnetic loop rapid anastomosis group and manual suture group. Intraoperative monitoring of vital signs and completion time of magnetic compression anastomosis were recorded. In the experimental group, to observe the position of the magnetic ring, X-ray examination was performed on the 3rd, 7th and 10th days, and the discharge time of the magnetic ring were recorded. The animals were sacrificed 4 weeks after the operation, the healing of the anastomotic stoma was observed, and pathological examination was conducted. Result Shooting from 5 m away animals, the modeling result were ideal. The entrance and exit of the bullet wound were clearly visible, the amount of bleeding was small, the intestinal penetrating injury was obvious, and one or more intestinal perforations were displayed. While shooting from 10 m away, amount of bleeding was large and more than half of the animals died. It took about 2 minutes to perform intestinal anastomosis with a magnetic ring, which was about 20 minutes shorter than the traditional manual suture, and the differences were significant. Post-operative X-ray showed that the magnetic ring was present in the bowel, and the magnetic ring was excreted with the stool within 2 weeks after the operation. Histological observation showed that the infiltration of inflammatory cells in the magnetic ring group was better than that in the suture group. Conclusion An animal model of abdominal bullet wound was successfully established. Compared with the traditional manual suture, the anastomotic magnetic ring has great advantages in the treatment of abdominal intestinal rupture caused by bullets, providing experimental support for the rapid treatment of field wounds in the future.

Key words: abdomen bullet wound, animal model, magnetic anastomosis

摘要： 目的 建立腹部枪弹伤大动物模型,并对腹部肠管破裂进行磁环吻合的初步应用研究,为野战手术的临床和基础研究提供理想动物模型。 方法 选用巴马小型实验猪,设置 5 和 10 m 两个距离使用国产 95 式步枪射击右下腹致伤,建立腹部枪弹伤动物模型。 选取造模成功的动物,随机分两组分别进行磁环吻合术和手工缝合术,术中监测生命体征,记录手术完成时间。 术后 3、7、10 d 进行 X 线检查观察磁环位置,并记录磁环排出时间。 术后 4 周安乐死动物,观察肠吻合口愈合情况并进行病理检查。 结果 距离射击点 5 m 造模结果较为理想,枪弹伤的出入口均清晰可见,出血量少,肠管贯通伤明显,肠穿孔显示 1 个或多个。 距离射击点 10 m 的造模后动物出血量大,死亡超过半数。 与传统手工缝合手术相比,采用磁环进行肠管破裂吻合需( 2. 08± 0. 14) min,两组手术时间差异有统计学意义(P<0. 01) 。 术后 X 线显示磁环存在肠管内,于术后 2 周内磁环随大便排出体外。 组织学观察显示磁环组炎性细胞浸润优于缝合手术组。 结论 成功建立了腹部枪弹伤大动物损伤模型,吻合磁环在枪弹所致腹部肠管破裂伤的救治手术中具有较大优势,为未来用于野战创伤快速救治提供实验支持。

关键词: 腹部枪弹伤, 动物模型, 磁吻合