法医学杂志

法医学杂志 ›› 1995, Vol. 0 ›› Issue (3): 0-0.

• 论文 •    

钝力性心脏外伤38例尸检病理学研究

李德祥   

  1. 中国医科大学法医学系
  • 发布日期:1995-06-25 出版日期:1995-06-28

PATHOLOGICAL STUDY ON BLUNT CARDIAC TRAUMA IN 38 AUTOPSY CASES

LI DEXIANG (FACULLY OF FARENSIC MEDICINE, CHINA MEDICAL UNIVERSITY; SHENYANG 110001)   

  • Online:1995-06-25 Published:1995-06-28

被引次数

20

摘要： 本文研究表明钝力作为原始致伤因素作用于胸部通过压、拉、剪切、旋转等可引起钝力性心脏外伤包括心脏震荡、心脏挫裂伤、心脏玻裂、心脏断离等原发性心脏外伤和继发性乃至迟发性心脏外伤，诸如外伤性心脏炎、冠脉血管炎、血栓形成、外伤性心肌梗塞、外伤性冠状动脉瘤、外伤性室壁瘤、迟发性外伤性心脏破裂等。致命性的心脏震荡，除急性冠循环障碍和心失常外，还可有心脏传导系统和神经组织损伤，尤其心肌肌膜爆裂（ｓａｒｃｏｌｅｍｍａｂｕｒｓｔ）及相应的原纤维膨出畸形变可以作为心脏震荡性外伤的形态学指证。外伤性心肌梗塞和迟发性外伤性心脏破裂以突然发生在外伤后的一定间隔期为特征，应予特殊注意．

关键词: 钝力性心脏外伤, 心脏震荡, 心脏挫裂伤, 外伤性心脏炎, 外伤性心肌梗塞

Abstract: The Pathological study on blunt cardiac trauma in 38 autopsy cases was performed. The results showed that: (1) The blunt cardiac trauma was of various types including primary, secondary and delayed. (2) The sarcolemma burst and corresponding myocardiac fiber sticking out in various shapes and deformity, were the primary traumatic injuries caused by blunt forces and were different from nontraumatic damages of myocardial fiber; (3) The blunt cardiac trauma should be accounted for the majority of death among any age and sex. Woman, child or old person have no immunity to the cardiac trauma. It must be pointed out that pre- existing pathological damages includinng atherosclerosis of the coronary artery may make these vesels or tissues particulary susceptible to blunt foces on the chest wall.

Key words: blunt cardiac trauma, cardiac concussion, traumatic carditis, traumatic myocardial infarction