犬腹部高速投射物伤后的肝脏病理变化及其机制  

Early hepatic pathologic changesafter abdominal inju-ry by high velocity projectil

作　　者：陈林[1] 王正国[1] 刘荫秋[1] 安波[1] 王建民[1] 张大春[1] 吴国萍[1] 周萍[1] 李叶君[1] 

机构地区：[1]第三军医大学野战外科研究所

出　　处：《中国危重病急救医学》1995年第1期5-7,共3页Chinese Critical Care Medicine

摘　　要：观察犬腹部高速投射物伤后早期肝脏病理形态变化。结果：①致伤瞬间肝脏表面均测到明显压力（平均约４００ｋｐａ）。②伤道出入口面积分别为２４３±９．７ｃｍ￣２，０．２１±０．０５ｃｍ￣２。部分动物有脾破裂、肠管穿孔或断裂、膀胱穿孔、腹腔内有积血等，肝脏多显淤血，色为较暗淡的红色，部分肝脏表面有小出血区。③光、电镜观察：伤后所有时间点肝脏均有明显的结构损伤（包括肝细胞变性、坏死等改变）。④肝组织丙二醛（ＭＤＡ）水平于伤后明显高于对照组（Ｐ＜０．０５），而肝脏有效血流量都明显低于伤前值。结论：本研究表明犬腹部高速投射物伤后早期可出现肝脏形态、功能的明显损伤。肝脏损伤的主要原因是肝脏血流量减少，压力波的作用显然不能忽视。The liver changes of the dogs abdominallywounded by high velocity projectile(HVP),The re-sult showed :1.An average pressure of about 400 kPacould be found on the liver surface at the time of in-jury.2. The areas of the entrance and exit of HVP were 24. 30± 9.70 and 0.21±0.05cm￣2respectively,some of the wounded dogs showedspleen repture,intestinal perforation or abruption,bladder perforation and pool of blood inside the ab-domen,et al.Most livers had a clo udy red color,onthe surface of some livers small areas of bleedingwere seen。3.Light and electronic microscopic exami-nation sbowed that the livers had obviousmorphological changes including constant degenera-tion and necrosis aftet in jury.4.The liver M A D levelwas significantly higher after injury than the controlgroup(p<0.05),and the effective hepatic bloodflow(EHBF)Was obviously lower than pre-injuryperio d,We co nclude that the livers of the dogswounded by high velocity projectiles to the abdomenwere obviously damaged.The decrease of EH BFplayed an important role in the occurrence of liverdamage,and the role of pressure wave in this processshould not be neglected.

关 键 词：高速投射物 肝脏 病理形态学 创伤 

分 类 号：R641.02[医药卫生—外科学] R602[医药卫生—临床医学]