犬颅脑爆炸伤后早期脑组织病理改变

目的 :研究犬颅脑爆炸伤后脑组织的病理特点。方法 :2 4条犬随机分为颅脑爆炸伤组和单纯颅脑弹片伤组。观察比较两组动物局部伤道、脑挫伤出血区范围、血脑屏障破坏程度、颅内血肿的发生率和脑水肿等病理变化。 结果 :爆炸伤组颅骨骨折、急性硬膜下血肿和蛛网膜下腔出血的发生比例均明显高于弹片伤组 ( P<0 .0 1) ,挫伤区蓝染范围明显大于弹片伤组( P<0 .0 1) ,爆炸伤后脑组织含水量显著高于弹片伤组 ( P<0 .0 5 )。爆炸伤组脑组织伤道呈梭形 ,约 10 mm× 15 mm大小 ,脑组织挫伤区与震荡区边界不清 ,全脑和颈髓有点状出血 ;弹片伤组脑组织伤道呈漏斗形 ,约 8mm× 12 mm大小 ,挫伤区宽度约为 ( 12± 1.8) mm。光镜下 ,颅脑爆炸伤后脑组织损伤以神经元和胶质细胞的变性和水肿为主。结论 :爆炸冲击波和弹片在对脑组织的致伤效能上具有叠加效应 ;原发性脑损伤多为可逆性损伤 ,继发性脑损伤出现早且较为严重 ,积极的早期治疗有非常重要的意义

Pathological changes in brain tissue at early stage of explosive injury in dogs

Objective: To study the pathophysiological changes after penetrating explosive injury to the brain. Methods: Simulating fragment of the explosive weapons with high speed steel spheres and considering explosive wave of electric detonator as explosive weapons' blast, an experimental model was developed in anesthetized dog. The physiological parameters and the pathological changes were recorded. Results: All 12 injured animals had apnea, which maintained for longer than 6 min in 5 of them, the other 7 began to breathe after 0.5 to 6 min. In addition to apnea, hypotension and bradycardia was observed within 30 min, and then returned to about the control value and remained for 3 4 h, then followed by decline in the rest of the animal's life. Intracranial pressure rose within a few seconds and peaked at 60 to 90 mmHg, and subsided to moderately elevated levels (25 to 40 mmHg) for at least 1 h, followed by a rise above 50 to 80 mmHg at 5 to 6 h after injury. Conclusion: Apnea, hypotension and bradycardia are observed in all injured animals, followed by restoration to the control value and remain there for 3 4 h, then followed by decline in the rest of animal's life. The intracranial pressure response to the penetrating explosive injury is bimodal with first trough occurring within seconds and second trough occurring 5 to 6 h after injury.