芥子气中毒合并腹部穿透伤的救治研究

目的：通过对芥子气中毒合并腹部穿透伤的伤情特点和急救的研究，为战伤救治提供依据。方法：实验免分为手术对照组、芥子气中毒对照组、芥子气中毒合并腹部穿透伤组、芥子气中毒急救合并腹部穿透伤组、芥子气中毒急救合并腹部穿透伤手术救治组共5组。结果：中毒合并腹部穿透伤兔未经救治在24h内均死亡，经手术及急救后死亡率为25％。主要死亡原因为枪弹伤所致的腹腔内大出血，同时存在腹腔内脏器多处损伤，伤情较重。芥子气中毒合并腹部穿透伤未经中毒急救、洗消，腹部伤口周围红斑、水肿严重，伤情更加复杂。结论：持久性毒剂芥子气局部中毒合并腹部穿透伤处理与速杀性毒剂中毒急救不一样，应先挽救危及生命的内脏器官损伤。如胃穿孔及肠系膜血管破裂出血、休克等，同时对局部染毒皮肤洗消，注意预防并发症。

Treatment of mustard gas poisoning combined with penetrating wounds of abdomen

Objective: To investigate treatment of mustard gas poisoning combined with penetrating wounds in abdomen and to provide scientific basis for first aid to combat casualties. Methods: The experimental rabbits were randomly divided into five groups: 1. the control group with surgical operation; 2. the control group of mustard gas poisoning; 3. the group of mustard gas poisoning combined with penetrating wounds in abdomen; 4. the group given first aid to mustard gas poisoning combined with penetrating wounds in abdomen; 5. the group given first aid to mustard gas poisoning combined with penetrating wounds in abdomen given surgical operation. Results: Animals with penetrating wounds left untreated all died within 24 hours, But the mortality of the animals treated with surgical operation and first aid was 25%. Death mainly resulted from severe gunshot injuries and multiple injuries in abdominal organs, leading to massive abdominal hemorrhage. Erythema and severe edema were clearly seen in the animals with mustard gas poisoning combined with abdominal penetrating wounds, as they remained untreated with first aid and decontamination, and the injuries seemed rather complicated. Conclusion: Emergency care for acute lethal poisoning was different from the treatment for persistent mustard gas poisoning combined with abdominal penetrating wounds, for which efforts should be made first to treat those life-threatening injuries to internal organs, such as stomach perforation, massive hemorrhage, shock etc. Then skin decontamination was performed and medical care should be taken to prevent complication.