肺冲击伤的病理组织学和超微结构变化

用200g TNT炸药在模拟激波管内爆炸,使管口处的14只狗、12只豚鼠和20只大鼠造成不同程度的冲击伤。伤后6～8h活杀,作肺的大体、光镜和电镜观察。除见有典型的肺出血和肺水肿外,电镜下见肺上皮细胞和毛细血管内皮细胞肿胀和细胞器变性,内皮细胞变化更为严重。毛细血管腔内有中性白细胞和血小板积聚、附壁和脱颗粒等表现,对其意义作了讨论。

Histopathological and Ultrastructural Changes in the Lung with Blast Injury

Lung samples are taken from 14 dogs, 12 guinea pigs & 20 rats injured by 200 g TNT explosion after 6 - 8 h, observed with light microscope & electron microscope (LM & EM). Animals dying within several min after injury show bleeding from the mouth and nose and dyspnea. By naked eyes: widespread hemorrhage and edema in the lungs are seen. By LMs interstitial and alveolar hemorrhage and edema, some ruptured alveoli, margination of neutrophils in the venulesi various degrees of neutrophilic infiltration in the alveolar septa are obrerved. By EM; large amount of RBC. edematous fluid, neutrophils, monocytes, deprivated type II pneumocytes, fibrin exudate and surfactant in mesh or packed form in alveolar lumen, some type II cells are swollen and vacuolized or disrupted, reduction or evacuation of lamina bodies, even degenerated. Most of the endothelial cells" are markedly swollen. There are significant pinocytosis and myeiln figure formation in some cell cytoplasm. In a cross section of a capillary only one CEC is swollen while the others are normal. No abnormal change in the alveolar septa is seen. In the early stage aggregation of RBC and WBC in capillary lumen, neutrophilic degranulation, migrination and dissolution of the neutrophilic cell membrane may be related to release of free radicals and destruction of endothelia. Aggregation, margination and degranulation of platelets are probably related to release of thromboxane A2.