多发性软组织挫伤后对肺及其他脏器的影响

The morphological changes of lungs and other viscera after multiple soft tissue contusions

目的观察多发性软组织挫伤后短时间内死亡案例的脏器病理学改变。方法应用常规组织学及免疫组织化学染色技术进行光学显微镜检查。结果光镜检查见肺组织毛细血管扩张充血，白细胞集聚，肺组织散在片状出血、灶状坏死及透明膜形成；心脏间质血管扩张充血，点灶状纤维溶解；脑组织充血水肿，肝脾充血。免疫组化发现肺泡腔及部分血管内纤维蛋白染色阳性，部分脾脏血管内及肾髓质集合管中肌红蛋白染色阳性。结论本研究结果提示多发性软组织挫伤后短时间内死亡的死因为成人呼吸窘迫综合征（ARDS）合并多脏器功能衰竭。

Objective To investigate the morphological changes of lungs and other viscera in the corps who died shortly after multiple soft tissue contusions,Methods Using routine histological and immunohistological stains. Results in microscope,the main features wer pulmonary capillary congestion with white blood cells agglutination, scattered hemorrhage and focal necrosis of pneumal tissue as well as hyaline formation in alveoli;cardiac capllary congestion and myolysis of myocardial fibers; congestion and edema in brain;congestion in liver and spleen. In immunohistological studies ,positive of fibronectin in alveoli and vessels was found;in addition, positive of myoglobin in spleen vessels and collecting tubes of kidney was seen.Conclusion These findings suggest that the death cause association with multiple soft tissue contusion is ARDS with visceral failure.