海水浸泡兔股动脉火器伤的病理学研究  

Pathological characteristics of seawater immersion following gunshot wounds of rabbit femoral arteries

作　　者：刘鹏[1] 赖西南 彭学良 刘晋才[1] 吴国萍[2] 张良潮[2] 王丽丽[2] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所骨科,重庆400042 [2]第三军医大学附属大坪医院野战外科研究所第六研究室,重庆400042

出　　处：《第三军医大学学报》2003年第5期373-376,共4页Journal of Third Military Medical University

基　　金：全军"九五"医药卫生指令性课题 ( 96L0 0 4 )

摘　　要：目的　观察兔股动脉火器伤合并海水浸泡的病理形态学特点。方法　将大白兔 3 0只随机均分为单一致伤组、海水浸泡 3 0min组和海水浸泡 60min组 ,用钢珠弹致伤兔单侧股动脉后 ,将海水浸泡组动物置于海水中浸泡 3 0min或60min ,单一致伤组动物不浸泡 ,于伤后 2、4、6、8、12h取弹着点中心两端股动脉 ,做光镜、电镜观察。结果　动脉损伤类型主要为完全断裂伤和挫伤。完全断裂伤的动脉分为原发伤道区、挫伤区和震荡区。与单一致伤组相比 ,海水浸泡组的原发伤道区和挫伤区的血管壁显著肿胀 ,以中膜外 2 3为甚 ,肌浆内空泡样结构常见 ,内皮细胞之间纵行皱褶紊乱、变平。浸泡 3 0min组与 60min组之间病变程度无明显差异。 3组中动脉挫伤和完全断裂伤的震荡区的病理表现类似。结论　兔股动脉完全断裂伤合并海水浸泡时 ,其原发伤道区和挫伤区的细胞、细胞间隙显著肿胀。Objective To investigate the pathological characteristics of a compound trauma, which refers to seawater immersion following gunshot wound of femoral artery. Methods A total of 30 rabbits were divided randomly into 3 groups: single wounded group (SWG, n =10), seawater immersion for 30 mins group(SIG Ⅰ, n =10) and seawater immersion for 60 mins group(SIG Ⅱ, n =10). Femoral arteries were impacted by 0.38 g steel balls fired from 7.62 mm rifle. After being wounded, rabbits in SIG Ⅰ, Ⅱ were immersed in seawater(saline 25.4, pH 8.2～8.4, temperature 21℃) for 30 or 60 mins. At 2 h, 4 h, 6 h, 8 h and 12 h following injury, segments of arteries measuring 40 mm on each side of the hit spot were extracted(every 10 mm as a unit) for the examination by light(H. E. and Verhoff's stain) and electron (TEM, SEM) microscopy. Results Types of arterial injury were contusion, complete and incomplete transection. Completely transected artery was divided as primary wound tract area, contused area and shocked area. Compared to those of SWG, primary wound track and contused area of artery of SIG manifested obvious swelling of arterial wall, especially at 2/3 outside of media. Balloon structures were often detected in smooth muscle cells of media, and intercellular space among smooth muscle cells were fulfilled by homogeneous, acidiphilic substance. Deep rugae among endothelial cells became flattened or rugal folds lost their strict longitudinal orientation, and marked fibrin and platelet deposition were noticed. No significant difference was detected between SIG Ⅰ and SIG Ⅱ. Pathological changes of contused artery were similar in 3 groups. Conclusion The pathological characteristics of seawater immersion following gunshot wounds of rabbit femoral arteries are obviously cellular and intercellular edema of arterial wall in primary wound track and contused area of completely transected artery.

关 键 词：股动脉火器伤 海水浸泡 病理学 合并症 

分 类 号：R654.3[医药卫生—外科学] R826.61[医药卫生—临床医学]