海水浸泡弹道伤骨髓肌组织的超微结构改变

目的 观察火器伤合并海水浸泡后肌组织的超微结构改变。方法 以滑膛枪发射质量为0.38g的钢珠，速度为600～800m/s，钢珠击中兔后肢，分别将致伤兔浸泡于海水中30分钟和1小时，对照组不浸泡。于伤后3、6、12、24小时在距伤道0.2～0.5cm(挫伤区）、0.5～1.5cm(震荡区）处取材，固定于2.5%的戊二醛中作电镜观察。结果 浸泡组弹道伤组织超微结构变化与对照组想像相似，以变性坏死为主，如肌原纤维变性、溶解、变散或发生坏死，形成电子密度高的无结构性团块，内质网扩张，线粒体肿胀、空化、髓鞘样变等，且上述改变随浸泡时间延长而加重。引人注目的是弹道伤组织，尤其是震荡区，伤后6小时出现一些形态结构相对正常的线粒体，12小时最为显著，24小时线粒体再度退变，肌原纤维坏死加重。结论 海水浸泡火器伤肌组织损伤程度较单纯火器伤明显加重，浸泡时间越长，损伤程度越重。伤后6～12小时内弹道伤组织线粒体出现代偿性增生改变。

The ultrastructural changes of firearm wounds of skeletal muscle tissue with seawater immersion

Objective To investigate the ultrastructural changes of skeletal muscle in firearm wounds with seawater immersion.?Methods All rabbits were randomly divided into three groups: 30min immersion group, 1h immersion group and control group. Steel sphere (weighing 0.38g, impact velocity 600-800m/s) hit the thigh of rabbits of immersion group. Then the rabbits were immersed in seawater for 30min or one hour.The tissue of skeletal muscle surrounding the wound track was excised and fixed in 2.5% glutaraldehyde to observe the ultrastructural changes.The treatment of rabbits of control group was similar to injury group except immersion.?Results The degree and range of degeneration, necrosis and dissolving of myofibrillae, the sarcoplasmic reticulum dilatation and the mitochondria swelling, emptying and forming myelin figure in the immersion group were more severe than those of the control group. However, at 6h and 12h postinjury, there still appeared a lot of relative normal mitochondria in the concussion zone. At 24h postinjury, the degeneration of mitochondria was much more significantly with myofibrillae dissolving and necrosis gravely.?Conclusion The degree of injury to the skeletal muscle of the firearm wounds with seawater immersion is severer than the control group.The longer the immersion, the severer it is. The mitochondria at ballistic injured tissue at 6h and 12h postinjury appear compensative hyperplasia.