超声在兔胸部撞击伤尸体检验中的初步研究  

Preliminary study of ultrasound in autopsy of rabbit chest impact injury

作　　者：程伟 门颖群 夏兵 尹志勇 李陶 CHENG Wei;MEN Yingqun;XIA Bing;YIN Zhiyong;LI Tao(Department of Ultrasound,Daping Hospital(Army Characteristic Medical Center),Army Medical University, Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院(陆军特色医学中心)超声诊断科

出　　处：《临床超声医学杂志》2019年第4期241-245,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金项目(81271586)

摘　　要：目的初步探索超声在兔胸部撞击伤尸体检验中的应用价值。方法选取健康新西兰兔16只,将其置于BIM-I型竖直生物撞击机下,采用850 g,直径40 mm的钢柱撞击胸部,以第四五肋间心前区为撞击中心模拟胸部钝性伤。撞击后应用超声对未立即死亡的动物行心脏左室壁厚度测量、左室血流动力学评估,行心包、胸腔积液检查和气胸检查,观察肋骨骨折情况;对撞击后立即死亡的动物行气胸检查和心包、胸腔积液检查,观察肋骨骨折情况。对未死亡的动物过量麻醉剂处死,所有动物死亡后均行尸体解剖,与超声检查结果对比。结果 12只兔撞击后未立即死亡,室间隔平均增厚(1.22±0.49)mm,左室后壁平均增厚(1.14±0.31)mm,与撞击前比较差异均有统计学意义(均P<0.05);左室短轴缩短分数平均降低(7.14±2.32)%,左室射血分数平均降低(10.16±2.77)%,与撞击前比较差异均有统计学意义(均P<0.05);心包积血、胸腔积血及肋骨骨折的超声诊断结果与尸体解剖结果比较诊断一致性均较好(均Kappa值>0.75);实验兔死亡后有肺挫裂伤者可探及气胸图像。结论超声可对胸部撞击伤进行准确评估,对心包积血、胸腔积血和肋骨骨折较为敏感,在尸体检验中有一定应用价值。Objective To investigate the application value of ultrasound in autopsy of rabbit chest impact injury. Methods Chest blunt trauma was stimulated in healthy 16 New Zealand rabbits through striking precordia using a BIM-I vertical bioimpacter equipped with 850 g,40 mm diameter steel rods. The impact center was located in the anterior region between the fourth and the fifth intercostal space. The left ventricular wall thickness,left ventricular hemodynamics,rib fracture, pericardial and pleural effusion as well as pneumothorax were evaluated by ultrasound immediately in animals temporarily surviving after striking. Surviving animals were executed with excessive anesthetic followed by autopsy. The findings of autopsy were compared with results from the ultrasonography. Results Twelve rabbit were not dead after trauma,temporarily. When compared with the rabbits before trauma,the average thickening of the interventricular septum and the posterior wall of the left ventricle was respectively increased by(1.22±0.49)mm and(1.14±0.31)mm,temporarily surviving after striking,both of which had statistical significance(P<0.05). The fractional shortening values of left ventricular short axis and ejection fraction values were both significantly decreased by(7.14±2.32)% and(10.16±2.77)%,respectively(P<0.05). The diagnostic results for pericardial hemorrhage,pleural hemorrhage and rib fracture evaluated by ultrasound was consistent with those from autopsy results(all Kappa>0.75). Pulmonary contusion and laceration were detected through pneumothorax sonogram in the died animals. Conclusion Ultrasound can be used to evaluate chest impact injury. Particularly,ultrasound is a sensitive method to determine pericardium,pleural hemorrhage and rib fracture. Therefore,it has a certain application value in autopsy.

关 键 词：超声检查 撞击伤 胸部 兔 

分 类 号：R445.1[医药卫生—影像医学与核医学]