电击伤最佳病理取材部位的初步研究

目的探讨日常低电压电击后机体电流通路上极向化等病变规律和最佳病理取材部位。方法SD大鼠随机分为电击组和对照组,建立左前爪-右后爪路径220V电击大鼠模型,取电极接触处皮肤、四肢血管、神经和周边组织及腹腔大血管,常规HE染色病理组织学图像分析。结果电极接触处皮肤基底细胞(skinbasalcell,SBC)核明显极向化改变,长/短径比值与对照组比较差异高度显著,P<0.001;电流通路上腕和踝部血管及腹主动脉内皮、平滑肌细胞核的极向化与对照组比较,差异显著,P<0.05,其中腕和踝部病理改变最明显;周围骨骼肌细胞核的长/短径比值无明显规律性。结论在电击死中最常见的“手-足通路”,腕、踝部血管可能为病理取材的最佳部位。同时,由于腕和踝部距离手脚掌较远,直接接触热源和化学试剂等其他可能引起“极向化”改变的因素机会少,因此,腕和踝部血管及其周边组织的极向化改变更具有电损伤的特异性。

A preliminary study for the promising locations showing significant pathological changes after electrical injuries

Objective To observe the pathological changes of cells after 220V alternative current injuries, in order to find out the locations showing promising significant changes.Methods SD rats were assigned at random to experimental groups and control. Left anterior and right posterior extremities were linked to live wire with 220v electric current. The blood vessels, nerves, skeletal muscles from four limbs and abdominal aorta were sampled and histological sections stained with H&E method. Long/Short ratio of cell nucleus axes were measured by image analysis system. Results The skin basal cell nuclei at the site of entrance and exit of electric current were obviously elongated, and showed very significant difference from the controls, P<0.001. In specimens taken from the wrist and ankle and abdominal aorta, the L/S ratio of vasc ular endothelial cell and smooth muscle cell nuclei also showed significant difference from the control, P<0.05, and the pathological changes at the wrist and ankle regions were more severe.Conclusion Our results indicate that gor the “hand-foot” passage, commonly encountered in cases of electrocution, the promising locations for getting specimens to identify electric injury are the vessels and their surrounding tissue at the wrist and ankle regions. In these locations the heat or chemical factors that could induce changes mimicking electrocution will not be expected. Therefore, the elongation of nuclei in vessel walls and the surrounding tissues at these locations might be characteristic for electric injury.