电流损伤的病理生理学及发生机制研究的新进展

Injury by electrical forces: pathophysiology, biophysics and pathogenesis

探讨电流损伤的发生机制及病理生理学改变,阐述电流的热效应与非热效应引起机体各器官病理学和病理生理学变化,揭示非热效应的选择性决定了远离触电点的脏器损伤,而临床上和法医实践中见到的损伤则是二者共同作用的结果,这给临床清创带来困难,法医学实践中无电流斑的死因推断也无从下手,由此阐明电流损伤的病理生理学和发生机制是非常重要的。

As the technologic sophistication of generation and distribution of electrical energy has grown, so has the general concern about the effects of electric fields on human health. There can be no doubt that the significance of electrical trauma will continue to grow with our increasing use of power. It is apparent that our understanding of the various forms of electric trauma must increase, while we continue to promote safety near electrical hazards and develop effective medical therapies. Tissue damage as a result of electrical injury occurs by two mechanisms which are summative in action and have a variable degree of contribute to the ultimate damage produced. Thermal tissue damage occurs as a result of heat generated within the tissue (which offer an electrical resistance ) secondary to the passage of the electrical current. High temperatures can also lead to cell membrane components, e.g, phospholipids, to dissolve. Electroportation damage is the tissue damage induced secondary to the strong electric field. Transmembrane potentials caused by electrical current result in the formation of pore in the phospholipid component of the cell membrane resulting in loss of function of the cell membrane with consequent cell death.