血管电损伤的实验研究

Experimental study on vascular injury induced by the electricity

观察电击后血管病理改变的规律及特点 ,探讨其损伤的发病机制和诊断电击伤 (死 )的价值。采用Wistar大鼠复制血管电击伤模型 ,通过HE、GS、Weigert弹力纤维染色和α actin免疫组化染色 ,观察电击后不同节段血管的病理变化。结果表明 :(1)电击后血管的损伤范围和程度均较其周围大 ;(2 )电击部位的血管常发生全层凝固性坏死 ,血管周围骨骼肌、脂肪细胞广泛坏死 ,大腔隙形成 ;距电击部位越远损伤越轻 ,血管损伤局限于管壁中内层 ,而血管周围组织相对完好 ;(3)光镜下 ,血管内皮细胞不同程度坏死、脱落 ;平滑肌肌浆凝聚 ,呈嗜碱性 (异染 ) ,胞核深染 ,扭曲伸长呈栅栏状排列 ,细胞内外大量汽化空泡形成 ,肌层中弹力纤维减少 ,网状纤维相互融合增粗、断裂 ,呈串珠状改变。TEM下见血管内皮细胞、平滑肌细胞内线粒体、内质网不同程度肿胀与扩张 ,甚至空泡化改变 ,平滑肌肌丝溶解 ,形成低电子密度区 ;汽化空泡边界清楚 ,无膜性结构 ,内无细胞器 ;SEM下见血管壁及腔面粗糙大小不等的腔隙形成 ;(4 ) 2 2 0V组血管的病理改变与 10 0 0V组相同 ,只是损伤程度较前者轻。电击后血管的病理改变是电热效应与电场作用的共同结果 。

An experimental animal model of electricity induced vascular injury had been established in Wistar rats.Vessels and their surrounding soft tissues at the different sites of the electrocution were observed with HE、GS、Weigert stain、α actin immunohistochemistry and electromicroscopy.Results were as follows:(1)The degree and the range of the vascular injury were more severe and wider than the surrounding soft tissues;(2)The coagulation necrosis of the vascular wall,skeletal muscles and fatty cells were found.Large cavities surrounding the vessels were seen.The lesions of the vessels were mild gradually from the central zone of the injury to the marginal area.The vascular injuries were localized at the inner and middle layer of the vascular wall;(3)The major pathological changes of vessels were as follows:necrosis and exfoliation of the endothelial cells.Coagulation necrosis of the smooth muscles with basophilic staining,stretched,distorted and deep stained nuclei,decreased elastic fibers of muscular layer,confluent,broken and bead like reticular fibers.Under TEM,mitochondria and endoplasmic reticulum of the endothelial and smooth muscular cells were swollen and distended.The myolysis of the smooth muscles was seen.Low electron density area and air vacuoles were observed.Under SEM,the vascular walls and the surface of their cavities were rough with the formation of small lacunaes;(4)The pathological changes of the 220V group were milder than those of the 1000V group.All results indicated above were quite useful for the pathological diagnosis for the electrocution.The pathogenesis of blood vessel injury was discussed.