人体颅脑贯通枪创后心肌和肺的超微结构观察

本文报告6例人体颅脑贯通枪创后2小时所取心肌和肺的超微结构变化。6例心肌及肺的超微结构基本相似。心肌最明显的变化是:Z 带排列不规则,灶性肌原迁维溶解,线粒体肿胀、基质电子密度降低和嵴消失,间质水肿。肺组织的明显变化是肺泡隔和肺间质增宽伴电子密度降低,肺泡隔毛细血管内中性粒细胞聚集,肺间质或肺泡腔内中性粒细胞浸润。本文对主要病理变化的意义和发生原理进行了讨论,认为肺间质水肿与神经源性肺水肿有关,由于伤后经过时间长短不同或有无颅内高压形成,而出现间质性水肿或肺泡内水肿。心肌的变化与缺氧有关。

ULTRASTRUCTURAL OBSERVATION ON HUMAN LUNG TISSUE AND MYOCARDIUM DIED OF CRANIOCEREBRAL PENETRATING GUNSHOT WOUND

U1 trastuctrural changes of myocardium and lungs from 6 cases died of cranioce-rebral penerating gunshot wound 2 hours after injury is reportcd.In all cases theelectron microscopy of the myocardial and lung tissue samples showed the similar ultrastructural morphological changes of the cells and interstitial tissues.The mostpr-ominent ultrastructural changes of myocardium were disorderly arrangement of the Zband.focal dissociation of the myofibrills,mitochondrial swelling with decreasing ofmatrix density and disruption of cristae,and interstial edema.The changes of theung tissue were increasing of width of alveolar septa with decreasing of the electron density.Aggregation of neutrophils in the capillaries of alveolar septa and some alveolar space was observed.The significance and the pathogenesis of the mainpathological changes were discussed.It is suggested that the pulmonary interstitialedema was neurogenic.The pulmonary edema may be manifested as interstitial edemaor intra-lveolar edema depending upon the time elapsed after the gunshot injury.