切换至 "中华医学电子期刊资源库"

中华损伤与修复杂志(电子版) ›› 2023, Vol. 18 ›› Issue (04) : 280 -284. doi: 10.3877/cma.j.issn.1673-9450.2023.04.002

专家述评

我国放射复合伤创面处理与创伤促愈的研究历程
冉新泽(), 王军平, 王涛, 王锋超, 程天民   
  1. 400038 重庆,陆军军医大学(第三军医大学)军事预防医学系全军复合伤研究所 创伤、烧伤与复合伤国家重点实验室
  • 收稿日期:2023-04-27 出版日期:2023-08-01
  • 通信作者: 冉新泽
  • 基金资助:
    军队后勤科研项目(ALJ19J002、ZLJ22J020)

Study on wound management and trauma healing of radiation combined injuries in China

Xinze Ran(), Junping Wang, Tao Wang, Fengchao Wang, Tianmin Cheng   

  1. Institute of Combined Injury of PLA, State Key Laboratory of Trauma, Burn and Combined Injury, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 400038, China
  • Received:2023-04-27 Published:2023-08-01
  • Corresponding author: Xinze Ran
引用本文:

冉新泽, 王军平, 王涛, 王锋超, 程天民. 我国放射复合伤创面处理与创伤促愈的研究历程[J]. 中华损伤与修复杂志(电子版), 2023, 18(04): 280-284.

Xinze Ran, Junping Wang, Tao Wang, Fengchao Wang, Tianmin Cheng. Study on wound management and trauma healing of radiation combined injuries in China[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(04): 280-284.

放射复合伤常见于战时核武器爆炸、平时核事故、贫铀武器伤害、次生伤害和恐怖伤害等情况,其伤情严重、种类复杂、救治困难,成为临床难点之一。复合伤有复合效应,因合并放射损伤因素的同时涉及伤口或创面等伤害,既不同于单纯的烧伤或创伤,也不同于单纯的急性放射病,远比单一损伤救治面广、矛盾多、难度大,必须充分吸取单一损伤的治疗经验和措施,及时能动地应用于复合伤研究。本文结合既往实验研究结果,重点总结放射损伤复合烧伤或创伤时创面处理的经验、方法与原则,创伤难以愈合的机制与促进愈合的措施,拟为此类核与辐射突发事件的应急处置提供技术储备。

Radiation combined injuries (RCI) are common in situations such as nuclear explosions in wartime, nuclear accidents in peacetime, depleted uranium bomb injuries in battlefield, secondary nuclear injuries, and nuclear terrorist attacks. RCI show more severe in trauma conditions and more complicated in injury category, which are hard for treatment and become one of the clinical difficulties. Combined effects are the primary features of combined injuries, which make RCI different from single type injury. Thus, RCI are different from simple acute radiation sickness because of the traumas like skin wounds and burns, and vice versa. So the therapy for RCI would be more difficult than that of single type injury for the more contradictories during RCI treatment. Therefore, it is necessary to fully draw on the research achievements of single type injury and apply them to research combined injuries in a timely and dynamic manner. Based on previous experimental research results, this paper focuses on summarizing the experience, methods, and management principles of wound management in radiation injury combined burns or wounds, as well as the mechanism of delayed trauma healing and measurements for promoting repair. It aims to provide technical reserves for the management of such nuclear and radiation emergencies.

[1]
程天民. 复合伤的概念与分类命名. 见:罗成基,粟永萍主编. 复合伤[M]. 北京:军事医学科学出版社,2006: 3-10.
[2]
Ran XZ, Shi CM, Zheng HE, et al. Experimental research on the management of combined radiation-burn injury in China[J]. Radiat Res, 2011, 175(3): 382-389.
[3]
冉新泽,程天民. 中国放射医学研究的发展与思考[J]. 中华疾病控制杂志2019, 23(11): 1305-1308, 1424.
[4]
龙爽,冉新泽. 放射性复合伤的生物效应机制[J]. 辐射防护通讯2016, 36(6): 1-5.
[5]
冉新泽,程天民,粟永萍. 放烧复合伤的造血保护与免疫调节研究[J]. 中华医学杂志2011, 91(12): 855-857.
[6]
Sharma AK, Prasad A, Kalonia A, et al. Combined radiation burn injuries: a note[J]. J Radiol Prot, 2022, 42(4): 043502
[7]
Chen X, Zhai D, Wang B, et. al. Hair keratin promotes wound healing in rats with combined radiation-wound injury [J]. J Mater Sci Mater Med, 2020, 31(3): 28.
[8]
程天民. 我国防原医学发展的回顾与思考[J]. 中华放射医学与防护杂志2014, 34(4): 241-244.
[9]
冉新泽,王军平. 一等功臣一代名师:记我国著名防原医学与病理学家中国工程院程天民院士[J]. 中华烧伤与创面修复杂志2023, 39(1): 1-4.
[10]
程天民,周善章. 犬急性放射性损伤复合烧伤并发感染的几个问题. 见:程天民院士科研教学与管理文选[M]. 北京:人民军医出版社,2006: 167-173.
[11]
冉新泽,阎永堂,林远,等. SD-Zn或SD-Ag涂抹创面和切痂植皮时机对放烧复合伤大鼠的疗效观察[J]. 中华整形烧伤外科杂志1997, 13(5): 330-334.
[12]
冉新泽,程天民. 放烧复合伤的发病机制与救治研究[J]. 中华放射医学与防护杂志2009, 29(3): 335-337.
[13]
冉新泽,阎永堂,程天民,等. 小面积Ⅲ度放烧复合伤创面处理的实验研究[J]. 中华医学杂志1997, 77(2): 154-156.
[14]
Ran XZ, Yan YT, Cheng TM, et al. The effect of skin grafting at different time post blood transfusion and bone marrow transplantation on rats combined radiation-burn injury[J]. Chin Med Sci J, 1998, 13(2): 112-115.
[15]
Ran XZ, Yan YT, Cheng TM, et al. Effects of the combined radiation and thermal injuny on the survival of skin allograft and immune function in rats[J]. Chin Med J, 1998, 111(7): 634-637.
[16]
程天民,冉新泽. 合并放射损伤的创伤难愈与促愈研究的进展与思考[J]. 中华放射医学与防护杂志2002, 22(3): 145-148.
[17]
Ran XZ, Cheng TM, Shi CM, et al. The effects of total-body irradiation on the survival and skin wound healing of rats with combined radiation-wound injury[J]. J Trauma, 2004, 57(5): 1087-1093.
[18]
刘建忠,周元国,程天民,等. 不同剂量软X线照射对大鼠伤口愈合影响规律的研究[J]. 中华放射医学与防护杂志2002, 22(3): 183-187.
[19]
Qu JF, Cheng TM, Shi CM, et al. A study on the activity of fibroblast cells in connection with tissue recovery in the wounds of skin injury after whole-body irradiation[J]. J Radiat Res (Tokyo), 2004, 45(2): 341-344.
[20]
舒崇湘,程天民,阎国和,等. 6Gy全身照射对皮肤伤口几种细胞外基质成分的影响及W11-a12的促愈作用[J]. 中华创伤杂志2001, 17(10): 604-607.
[21]
Shi CM, Qu JF, Cheng TM. Effects of nerve growth factor on the survival and wound healing in mice with combined radiation and wound injury[J]. J Radiat Res, 2003, 44(3): 223-228.
[22]
王涛,赵娜,龙爽,等. 皮肤创伤愈合的转录组学研究进展[J]. 中华损伤与修复杂志(电子版), 2019, 14(2): 136-140.
[23]
闫国和,粟永萍,艾国平,等. 羊膜负载骨髓间充质干细胞与表皮细胞对放创性皮肤损伤促愈合研究[J]. 中国修复重建外科杂志2004, 18(6): 497-501.
[24]
Shi CM, Cheng TM, Su YP, et al. Transplantation of dermal multipotent cells promotes the hematopoietic recovery in sublethally irradiated rats[J]. J Radiat Res(Tokyo), 2004, 45(1): 19-24.
[25]
Zong ZW, Cheng TM, Su YP, et al. Crucial role of SDF-1/CXCR4 interaction in the recruitment of transplanted dermal multipotent cells to sublethally irradiated bone marrow[J]. J Radiat Res (Tokyo), 2006, 47(3-4): 287-293.
[26]
Long S, Wang G, Shen M, et al. dTMP-GH fusion protein therapy improves survival after radiation injury combined with skin-burn trauma in mice[J]. Radiat Res, 2019, 191(4): 360-368.
[27]
Wang Z, Chen Z, Jiang Z, et al. Cordycepin prevents radiation ulcer by inhibiting cell senescence via NRF2 and AMPK in rodents[J]. Nat Commun, 2019, 10(1): 2538.
[28]
李娟,赵雅贞,冉永红,等. 创面放射性沾染的处置效果研究[J]. 局解手术学杂志2020, 29(3): 175-179.
[29]
Du Z, Liu H, Huang X, et al. Design and synthesis of a mitochondria-targeting radioprotectant for promoting skin wound healing combined with ionizing radiation injury[J]. Pharmaceuticals, 2022, 15: 721.
[30]
汪国建,谭雨龙,龙爽,等. 高温高湿环境暴露对重度放创复合伤小鼠损伤恢复的影响[J]. 中华损伤与修复杂志(电子版), 2023, 18(4): 285-292.
[31]
全勇,冉新泽,胡梦佳,等. 低氧习服在小鼠造血干细胞急性放射损伤修复中的作用观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(4): 293-298.
[32]
李勇,全勇,傅仕艳,等. 低氧环境对小鼠急性放射损伤的影响[J]. 中华损伤与修复杂志(电子版), 2023, 18(4): 299-305.
[1] 王涛, 冉新泽, 王军平. 放射复合伤的研究进展与展望[J]. 中华损伤与修复杂志(电子版), 2023, 18(04): 353-357.
[2] 全勇, 冉新泽, 胡梦佳, 陈芳, 陈乃成, 廖伟年, 陈默, 申明强, 陈石磊, 王崧, 王军平. 低氧习服在小鼠造血干细胞急性放射损伤修复中的作用观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(04): 293-298.
[3] 王德运, 褚志刚, 栾夏刚. 重症烧伤的早期救治[J]. 中华损伤与修复杂志(电子版), 2021, 16(05): 383-388.
[4] 胡骁骅, 李忠僖, 沈余明, 杜伟力, 滕星. 小腿骨筋膜室综合征创面及后遗症的序贯治疗[J]. 中华损伤与修复杂志(电子版), 2017, 12(01): 13-21.
[5] 魏晓明, 程智礼. 肝创面对拢缝合与创面敞开短期临床结局的对比研究[J]. 中华普通外科学文献(电子版), 2015, 09(04): 300-303.
[6] 薛飞, 黄平平. 间充质干细胞治疗急性放射性损伤的研究[J]. 中华细胞与干细胞杂志(电子版), 2018, 08(02): 120-124.
阅读次数
全文


摘要