人脾破裂损伤时间推断的法医病理学分析  

Forensic pathology analysis of time inference of human spleen rupture injury

作　　者：周明杰 ZHOU Ming-jie(Fujian Zhengyang Judicial Identification Institute,Fujian Ningde 352000,China)

机构地区：[1]福建正扬司法鉴定所

出　　处：《临床医药文献电子杂志》2019年第60期15-17,共3页Electronic Journal of Clinical Medical Literature

摘　　要：目的分析人脾破裂损伤时间推断的法医病理学特征。方法选取72例2017年6月~2018年12月在我省各医院治疗的外伤性脾破裂患者,取其手术标本,依据脾破裂损伤的时间,将本组患者分为8组,即A组(0~6h),B组(7~12)h,C组(13~24)h,D组(25~48)h,E组(49~72)h,F组(73h^7d),G组(8~14)d,H组(>14)d。对各组患者的标本进行染色,详细分析人脾破裂损伤时间推断的法医病理学特征。结果A组可见纤维素渗出,个别中性粒细胞出现浸润;B组可见纤维素渗出,有大量的中性粒细胞出现浸润;C组可见少量的SMA阳性细胞分布;D组见大量的SMA阳性细胞呈网状分布;E组中见大量的SMA阳性细胞呈放射状分布;F组和G组可见肉芽组织形成,H组中见疤痕形成。结论法医学中在对脾破裂损伤时间进行判断时,应以破裂出血区边缘组织学的变化情况为主,将纤维素的渗出、中性粒细胞浸润、SMA阳性细胞的数量以及分布等作为辅助指标。Objective To analyze the forensic pathological features of human spleen rupture injury time.Methods 72 patients with traumatic splenic rupture treated in our hospital from June 2017 to December 2018 were enrolled.The surgical specimens were taken according to the time of spleen rupture injury.The patients were divided into 8 groups,namely A.Group(0~6h),B group(7~12)h,C group(13~24)h,D group(25~48)h,E group(49~72)h,F group(73h^7d),group G(8~14)d,group H(>14)d.The specimens of each group of patients were stained,and the forensic pathological features inferred from the time of spleen rupture injury were analyzed in detail.Results Cellulose exudation was observed in group A,and infiltration of individual neutrophils was observed.In group B,cellulose exudation was observed,and a large number of neutrophils were infiltrated.In group C,a small amount of SMA-positive cells were observed.The SMA-positive cells were distributed in a network;in the E group,a large number of SMA-positive cells were radially distributed;in the F and G groups,granulation tissue was observed,and in the H group,scar formation was observed.Conclusion In the forensic medicine,when judging the time of spleen rupture injury,the changes of the histology of the ruptured hemorrhage area should be taken as the main point,the cellulose exudation,neutrophil infiltration,the number and distribution of SMA positive cells,etc.Auxiliary indicators.

关 键 词：人脾破裂损伤 时间推断 法医诊断 病理学分析 

分 类 号：R657.62[医药卫生—外科学]