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目的观察火器伤所致的肺部病理形态学改变特点,为临床救治提供理论参考。方法回顾性分析34例火器伤尸体解剖资料,包括6例胸部火器伤和28例非胸部火器伤。在28例非胸部火器伤中,颅脑火器伤7例,腹部火器伤8例,腹部合并四肢火器伤4例,四肢火器伤6例,四肢合并血管火器伤2例,四肢合并腰椎火器伤1例。分析各病例肺部病理形态学改变。结果胸部火器伤者致肺部损伤,胸壁上有不同的伤口、伤道出血、血块及坏死组织,胸腔可见血胸、血气胸或脓胸、胸膜粘连;可见到正常、萎缩或肿胀肺;切面可见肺水肿、肺栓塞、肺脓肿、肺出血、坏死灶及肺小动脉内栓子等特征表现;镜下见到肺水肿、肺栓塞、肺部炎症、急性呼吸窘迫综合征等特征性改变。非胸部火器伤者也可见到胸腔和肺组织出现不同程度的病理改变。结论火器伤可有各种不同程度的胸腔和肺部病理学改变。急性肺水肿、肺栓塞、肺部感染、急性呼吸窘迫综合征等是火器伤常见肺部并发症及加快死亡的原因之一。
Objective To observe the pathological changes of the lung caused by firearm injury and provide theoretical reference for clinical treatment. Methods The autopsy data of 34 cases of firearm injuries were retrospectively analyzed, including 6 cases of chest firearm injuries and 28 cases of non-chest firearm injuries. In 28 cases of non-thoracic firearm injuries, there were 7 cases of craniocerebral firearm wounds, 8 cases of abdominal firearm wounds, 4 cases of firearm wounds of the abdomen with limbs, 6 cases of firearm wounds of the extremities, 2 cases of arms and firearm injuries of the extremities, 2 cases of firearm injuries of limbs and lumbar vertebrae 1 example. Analysis of the pathological changes in the lungs of various cases. Results chest firearm injury caused by lung injury, chest wall with different wounds, bleeding wounds, blood clots and necrotic tissue, chest visible hemothorax, blood pneumothorax or empyema, pleural adhesions; can be seen normal, atrophy or swollen lung; section Pulmonary edema, pulmonary embolism, lung abscess, pulmonary hemorrhage, necrosis and pulmonary arterial embolism can be seen; characteristic changes such as pulmonary edema, pulmonary embolism, pulmonary inflammation and acute respiratory distress syndrome were seen under the microscope. Non-chest firearm injuries also showed varying degrees of pathological changes in the thorax and lung tissue. Conclusion Firearm injuries have varying degrees of pathological changes in the thorax and lung. Acute pulmonary edema, pulmonary embolism, pulmonary infection, acute respiratory distress syndrome and other common lung complications of firearm injuries and speed up the death of one of the reasons.