高速钢珠弹致股骨骨折及软组织创伤后肺病理形态变化的动物实验

本文报道用7.62mm,1.03g钢珠射击11只猪股骨,致股骨粉碎性骨折后肺组织和超微结构的变化。结果表明,伤后24h,肺微血管充血、红细胞、白细胞聚集。白细胞显脱颗粒。内皮细胞基底膜溶断,Ⅰ型上皮细胞肿胀、变性。Ⅱ型上皮细胞板层体急性排空。伤后48、72h病变逐渐减轻。这些病理变化与成人呼吸窘迫综合征(ARDS)时的病变相似,但病变程度较轻,预后良好,多数动物不伴有明显的ARDS症状和体征。实验结果提示肢体创伤可诱发一种亚临床型ARDS。

Pathological Changes of the Lungs after High-velocity Steel Bullet-induced-Bone Fracture in Pigs

The histopathological and ultrastructural changes of the lungs of 11 pigs suffering from comminuted fracture of the femur produced by high-velocity sieel bullet were studied. The steel bullet was 7.62 mm in diameter and 1.03 g in weight. The pulmonary changes were observed 24, 48, and 72 hours after injury.It was found that microvascular congestion, aggregation of RBC and WBC, and degranulation of WBC were prominent features 24 hours after injury. The basement membrane of the endothelium was broken. Type I pneumocytes became swollen and deteriorated. The lamellar bodies of Type II pneumocytes were evacuated rapidly. 48 to 72 hours after injury, these pathological changes gradually ameliorated.The pulmonary pathology occurring after bullet - induced fracture observed in this study is similar to that of adult respiratory distress syndrome(ARDS) in character but much milder in intensity. Its prognosis is always fine. Most of the experimental animals showed no symptoms or signs of ARDS. It is concluded that severe limb trauma can induce subclinical ARDS.