多发性软组织挫伤后成人呼吸窘迫综合征──组织学及免疫组织化学研究

本研究应用组织学Ｈ·Ｅ、Ｍａｌｌｏｒｙ、ＰＴＡＨ以及免疫组织化学染色方法对６例多发性软组织挫伤后成人呼吸窘迫综合征者肺组织改变进行了深入探讨。结果表明，所有外伤性呼吸窘迫综合征者肺组织均呈急性充血、出血及水肿改变，且免疫组织化学染色证明，水肿液中含有纤维蛋白（原）成份。在６例中２例可见肺组织局灶性出血坏死，３例有散在性血管内纤维蛋白柱形成及肺泡内透明膜形成。这些改变均属成人呼呼吸窘迫综合征的早期肺损伤。对多发软组织挫伤后呼吸窘迫综合征的形成机理进行阐述。

Posttraumatic Adult Respiratory Distress Syndrome due to Multiple Soft Tissue Contusions-A histological and immunohistochemical study

The present study was conducted on lung tissues from six cases died from adult respiratory distress syndrome (ARDS) following multiple soft tissue contusions by histological H.E., Mallory's and PTAH staining methods, and immunohistochemical avidin-biotin complex method. The results showed polmonary acute intravascular congestion, intra-alveolar hemorrhage and cdema in all the six cases, pulmonary focal hemorrhagic necrosis and disseminated intravascular hyaline membrane formation in two and three cases respectively. Fibrin or fibrinogen or intra-alveolar edematous fluid was detected by immunohistochemical technique. All the aforementioned findings were consistent with the early stage of ARDS developmet.The possible pathogenesis of posttraumatic ARDS was discussed.