Ⅰ～Ⅳ度冻伤组织病理结构的变化

Changes of Histopathologic Structure of Ⅰ～Ⅳ Degree Frostbite

目的 探讨冻伤后组织病理结构的变化 ,为冻伤诊断和治疗提供参考依据。方法 用大耳白家兔进行复制Ⅰ～Ⅳ度冻伤模型 ,在冻伤后 12 ,2 4 ,4 8,72h时分别采取冻伤组织标本 ,常规HE染色 ,用显微镜观察其冻伤后组织病理结构的变化。结果 轻度冻伤 (Ⅰ～Ⅱ度 )后 12～ 2 4h时 ,表皮和肌肉组织结构基本正常 ,有轻度水肿 ;至 4 8～ 72h时 ,水肿略有加重 ,有白细胞浸润 ,偶见有灶性出血。重度冻伤(Ⅲ～Ⅳ度 )后 12～ 2 4h时 ,表皮和肌肉水肿明显 ,血管扩张出血 ,毛囊皱缩 ,有较多白细胞浸润 ;至 4 8～72h时 ,表皮和肌肉损伤严重 ,表皮及附属器结构模糊 ,血管壁有坏死改变 ,横纹肌横纹消失 ,肌浆凝固 ,肌间细胞呈条带状增生 ,有大量炎细胞浸润。结论 随着冻伤程度加重和冻伤后时间延长 。

Objective To explore changes of histopathologic structure after frostbite and to provide criteria for frostbite diagnosis and treatment.Methods Rabbits were used to reconstruct frostbite models of Ⅰ～Ⅳ degree.Specimens of frostbite tissue were colleted at 12,24,48,and 72 h respectively after frostbite and routine HE staining was used.Changes of histopathologic structure after frostbite were also observed under microscope. Results For light frostbite(Ⅰ～Ⅱ Degree),epithelial and muscular structures appeared normal except light edema at 12～24 h.Edema became slightly obvious with WBC infiltration and a few focal hemorrhages as 48～72 h after frostbite.For severe frostbite(Ⅲ～Ⅳ degree),there were obvious edema of epithelium and muscle,vascular dilatation and hemorrhage,atrophy of hair follicles and infiltration of leukocytes as 12～24 h.At 48～72 h after frostbite,however,there was severe injury at epithelium and muscle with unclear structure of epithelium and the appendices,necrosis of vessel wall,stria disappearance of striated muscle,karyoplasms coagulation,cell proliferation like belt between muscular cells and infiltration of a large number of inflammatory cells.Conclusions Damages to histopathologic structure became severe with time and degree of frostbite.