急性中毒致死28例尸检病理研究.docVIP

急性中毒致死28例尸检病理研究 　　【摘要】目的 探讨急性中毒致死的病理学诊断依据。方法 收集2001年10月至2012年6月受理的28例急性中毒致死尸检案例，其中10例有毒气体、7例农药、6例毒品、3例酒精和2例药物。采用大体和HE镜下观察。结果 28例急性中毒致死尸检中22例有肉眼改变，其中7例一氧化碳中毒者尸斑、肌肉、内脏器官和血液呈樱桃红色，11例胃黏膜点片状出血和8例心外膜点状出血；光镜下有9例心肌间质出血，18例肺出血，12例支气管痉挛，4例脑出血，11例肝细胞坏死，7例肾小管坏死和11例胃黏膜出血。6例口服农药中毒者除胃黏膜出血外，其中有3例胃内容物性状改变和3例胃内逸出农药气味；光镜下均见胃壁急性炎伴坏死。吸毒者常患有慢性肝病、心肌脂肪浸润伴心肌萎缩、间质性肺疾病、肺异物肉芽肿等多个器官的慢性病变。结论 病理学检查有助于某些急性中毒致死的诊断，并可为急性中毒治疗研究提供形态学基础。 【关键词】急性中毒；一氧化碳；农药；毒品；酒精；药物；尸体解剖；病理学 Pathology of acute poisoning： an autopsy study of 28 cases Luo Botao，Jie Wei，Jiang Hanguo，Zhao Yinghai，Chen xiaoyi. Department of Pathology of Guangdong Medical College，Zhanjiang 524023，China Corresponding author：Luo Botao， Email：jim0120424@21 【Abstract】Objective To investigate the value of pathological examination in the diag- nosis of lethal cases due to acute poisoning. Methods The macroscopic and microscopic find- ings in 28 autopsy cases（10 cases of toxic gas， 7 cases of pesticide， 6 cases of drug， 3 cases of alcohol and 2 cases of chinese herbal medicine）died of acute poisoning during the period from October， 2001 to June， 2012 were retrospectively reviewed. Results Gross Changes were found on gross examination in 22 of the 28 cases studied. Of them， 7 cases died of acute carbon mono- xide poisoning had showed cherry red of Shiban， muscle， visceral organs and blood. In addition， 11 and 8 cases had been found gastric mucosa hemorrhage and epicardium petechial hemorrhage respectively. Histologically， myocardial interstitial hemorrhage was observed in 9 cases， pulmon- ary hemorrhage in 18 cases， bronchospasm in 12 cases， cerebral hemorrhage in 4 cases， hepato- cyte necrosis in 11 cases， renal tubular necrosis in 7 cases and gastric mucosa hemorrhage in 11 cases. In 6 cases of oral pesticides poisoning， besides they had all gastric mucosa hemorrhage， the change of character of gastric contents was found in 3 cases and pesticide odor from stomach in 3 cases. In addition， acute inflammatory and necrosis of gastric w