大鼠颅脑爆炸伤后脑组织病理变化研究
颅脑损伤；,,脑水肿；爆炸伤；病理学,材料与方法,1实验动物与分组,2主要试剂及仪器,3实验方法,结果,讨论,参考文献：
摘要： 目的 研究大鼠颅脑爆炸伤后损伤区脑组织病理变化特点以及脑水肿的类型。方法 Wistar成年大鼠96只，随机分为爆炸伤组和对照组(n＝48)。2组动物均于右侧颞顶部开一直径为10mm骨窗。80mg TNT当量电雷管于5cm垂直距离爆炸致伤，分别于伤后4、12小时、1、2、5、7天观察损伤区脑含水量、光、电镜病理变化及伊文氏兰血脑屏障通透性改变。结果 损伤区呈进展性脑水肿，并于伤后2天达高峰，在伤后4～12小时主要以损伤中心血管扩张充血和细胞间质水肿为主要表现，部分血管破裂出血，电镜观察以血管内皮细胞受损改变为主；伤后1～2 天出现深层白质神经元和胶质细胞的水肿，但此部位血管内皮细胞受破坏不明显，伤后5～7天，脑水肿表现逐渐减轻。在伤后4小时和12小时，伊文氏兰(EB)渗出主要局限于损伤中心，随着时间的延长，尽管脑水肿程度加重，但EB渗出范围无明显扩大。结论 爆炸伤早期以血管源性脑水肿为主要表现，后期继发性的细胞毒性脑水肿可能为爆炸伤后脑水肿的主要原因。关键词：脑水肿；爆炸伤；病理学
Pathological changes after explosive injury of brain in rats
CHU Yanfei，LI Bingcang，CHEN Jing，et al.
(Institute of Surgery Research,Daping Hospital,Third Military Medical University,Chongqing 400042,China)
Abstract: Objective To study pathological changes of explosive injury of brain in rats.Methods Adult Wistar rats were divided into explosive injury group and control group (n=48) at random.The rats(n=48) were injured by 80mg detonators exploded at 5cm distance.Leakage of Evans blue from brain vessels,encephaledema index and pathological changes of injured brain were observed 4,12 hour, 1, 2, 5, and 7 day after injury.Results Brain edema was progressive in the area of injury.Brain edema reached its peak on day 2 after injury.Blood vessel dilatation,interstitial edema and hemorrhage can be observed in the center of the damaged brain 4 hour or 12 hour after injury.At the same time,damaged vascular endothelial cell could be seen by electron microscope.More water concentrated in neuron and gliocyte of white matter 1 or 2 day after injury.However,damaged vascular endothelial cell could not be seen in these areas.Brain edema decreased gradually on day 5 and day 7 after injury.Evans blue leak out from brain vessels in the core of the injured brain 4 hour and 12 hour after explosive injury of brain.The area of leakage of Evans blue did not enlarge although brain edema has been exaggerated.Conclusion The result indicated that the edema in the early period of explosive injury was vasogenic brain edema, and cytotoxic brain edema was the main reason of edema at the latter time. ......
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