实验性心脏震荡的法医病理学研究

本研究应用可产生稳定打击速度并可同时测定瞬间冲击速度及冲击力大小的机械式弹性拉力打击器，分别以６．７ｍ／ｓ及８．０ｍ／ｓ速度冲击大胸骨部心前区建立了心脏震荡动物模型，在左右心室压力及心电图监测下冲击后６０分钟进行尸体剖验检查，并应用多种组织化学染色、透射电镜技术、免疫组织化学染色以及硝酸镧示踪电镜技术对心肌组织学行系统性研究。结果表明：１．心前区受冲击瞬间左右心室内压力急骤升高，随即可恢复至正常水平。心电图在冲击后即刻表现为持续短暂的异常心律，逐渐恢复至正常心律。２．心脏血管麻痹性扩张，但宏观及微观均无损伤性所见。３．心肌超微结构有一定程度损害，心肝细胞膜破裂或通透性增高。本研究提示：心脏震荡者心脏宏观、微观无特殊改变，但超结构及心肌细胞膜轻度损害。

Study on Forensic Pathological Experimental Cardiac Concrssion

In the present study the animal mode of cardiac concussion was developed by impact to the precardial region at sternum at velocities of 6.7m/s and 8.0m/s respectively with mechanical elastic-cord propelled impactor in dogs.After impact,the left and right intraventricular pressures, and ECG were continuously monitored for 60 min.At the end of each experiment autopsy was performed for systemic evaluation of myocardium by histochemistry,electron microscopy, immunohistochemistry as well as lanthanum probe technique.The results revealed as follows: 1.immediate after impact to the precardial region abrupt left and right ventric ular hypertension were measured followed by normaliging to the preimpact values.immediate arrhythmias were recorded and lasted transiently with restoration to pre-impact sinus rhythm. 2. Paralytic vasodilatation of subepicardial vessels was noted in the heart with no lesions found at gross examination and microscopy. 3. Some ultrastructural damages in myocardium and increased cardiac cell membrane permeability were detected. The study suggests that although on specific changes in myocardial macro-and micro-structure in cardiac concussion can be demonstrated, slight damages to the myocardial ultrastructure and cell membrane permeability can be detected.