| The liver impact injury (LII) is an occlusive injury always results from direct impact on the thorax and abdomen by passive violence. Its usual causes are traffic accident, falling down from a high place and strike with great force etc. Nowadays, the occurring rate of LII induced by traffic accidents is increasing with the development of urbanization and modern communication and transportation. However, few reports have been published on study of the LII and blood viscoelasticity changes and mechanism of affecting the body after LII. In this study, after the models of LII in animals and hepatic blood flow mathmatical model after LII were established, we i explored characteristic of blood viscoelasticity changes ,the clinical significance and mechanism of affecting the body after LII. Meanwhile,we investigated the basic histopathological features of liver and the effects of myocardial systolic function and arterial blood gas subjected to LII.The part as follow is the results and conclusions of the study: the relation of the liver injury to dynamic factors and responses during the impact was investigated 1. The model of LII in animals has the advantages of simple manipulation of impacting equipment, controllable physical parameters and accuracy and repeatability in impacting sites. The pathology, type and wound state of the LII in the animals are similar to those seen in clinical practice. They are in the range of grade Ⅲto grade V according to AAST grading standards and 3~5 points in accordance with the AIS scoring. LII is complicated with costal fracture and injury of the heart and lungs. The model can be used for analysis of dynamic factors, detection of many indices and imaging diagnosis with SPECT. 2. The basic histopathological features of LII were loss of normal structure of hepatic lobules, hemorrhage, necrosis, hepatocytic swelling and degeneration, vacuolation and neutrophil infiltration. In the animals complicated with pulmonary injury, the hepatocytic emboli were occasionally seen in small arteries in the lungs. This finding suggests that hepatic cells exfoliated and reached the pulmonary blood vessels with the blood circulation to form emboli when the liver is impacted to rupture. It is of important value for clinical practice for it is helpful for the further understanding of the histopathological characteristics of LII in complication with pulmonary injury. 3. In the study ,we utilize diffuse equation on the basis of condition of radionucide movement in blood to construct hepatic blood flow mathmatical model, make a draft according the model with actural time-radioactivity curve of hepatic blood flow in rabbits, calculate every paramete of the model before and after hepatic impact injury in rabbits, thus provid the basis for the diagnosis of hepatic injury. 4. After LII in rabbits,blood viscosity was decreasing with shear rate's increasing at the same time;and was increasing with time's increasing at the same shear rate.The levels of blood viscosity(η')and elasticity(G') were increasing with time's increasing at the same shear rate; and at the same time the level of η'was increasing with shear rate's increasing after short-time decreasing, and reached its peaks when ? was 1.627; the level of G'was increasing with shear rate's increasing,and reached its peaks when ? was 3.000. Therefore, besides earlier-period anti-shock measures,one of the major measure for comprehensive treatment after LII should reduce post-traumatic abnormal blood viscosity, improve hemorrheological status of the terminal circulation of tissues,protect and maintain organ function,and prevent the complication.The study provides an experimental foundation for clinical reducion of post-traumatic abnormal blood viscosity in earlier 5. In this study, after injury ,heart rate (HR), left ventricular systolic pressure(LVSP),±dp/dtmax descented significantly,and left ventricular end-diastolic pressure (LVEDP) had not obvious significance in statistics.At the same time, pH and HCO3-fell gradually,and negative BEecf improve significantly, gradually metabolic acidosis had happened. PCO2 had not obvious significance in statistics,and PO2 decreased gently. Therefore, after LII , myocardial systolic function descents, disorder of acid-base balance is metabolic acidosis. |
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