颅脑损伤后心内膜下出血的病理及心电图改变

研究颅脑损伤后心内膜下出血的病理改变及其法医学意义。利用68例颅脑损伤的尸检和临床病历资料，以及相应心内膜下出血的心脏标本，以病理组织学方法观察心肌损害，分析心电图异常图形。结果显示：早期主要为左心室内膜下新鲜出血，浅层心肌出血，心肌散在灶状变性、横纹消失等心肌缺血性改变。晚期主要为以多形核白细胞为主的浸润，成纤维细胞增多，早期心肌瘢痕形成等心肌梗死样改变。21倒心电图异常以窦性心动过速和ST-T改变为主，严重的出现心律紊乱和房室传导阻滞。研究颅脑损伤后心内膜下出血的病理改变和心电图异常，在法医学实际检验鉴定和临床救治方面有重要的应用价值。

Study on Pathological changes of heart and electrocardiogram in cases of cranio-cerebral trauma

For the purpose of studying the pathalogical changes and its forensic medicalsignificance of subendocardial hemorrhage taken from bodies of cranio-cerebral trauma. Basedon 68 clinical literature cases, postmortem examinations and the corresponding hearts ofsubendocardial hemorrhage, we observed the myocardium injury and analysed the unusualelectrocardiogram using the method of histopathology. The results showed that in the earlythere were earlier myocardial changes of blood deficit such as fresh subendocardial hemorrhage in the left ventricle, myocardial internal hemorrhage in the superficial layer, smallscattered myocardial denaturat-ion and disappearance of striae etc, and that in the later therewere myocardial infarcti-on changes such as infiltration of inflammatory cells (mainly polymorphs), addition of fibrous cells etc. Among these cases, there were 21 cases of unusualelectrcrcardiogram with sinus tachycardia and change of ST-T, cardiac arrythmia and atrioventricular block appeared when it was serious. The study on pathological changes ofsubendocardial hemorrhage and electrocardiogram was applied to the forensic medicine andclinic practice.