| 摘要: |
| 目的：利用动物模型探索超声在胸部尸体检验中的价值。方法：健康新西兰兔16只，在BIM-I型竖直生物撞击机下，采用850g，直径40mm的钢柱撞击胸部，撞击中心在第4,5肋间心前区，模拟胸部钝性伤；撞击后对未立即死亡动物超声进行心脏左室壁厚度测量、左室血流动力学评估、肋骨骨折情况、心包及胸腔积液检查、气胸检查；撞击后死亡动物仅行气胸检查、肋骨骨折、胸腔及心包腔积液检查；未死亡动物过量麻醉剂处死，所有动物死后进行尸体解剖，与超声结果比对。结果：撞击后未立即死亡动物室间隔平均增厚1.21mm，左室后壁平均增厚1.13mm，具有统计学意义（p＜0.001）；左室射血分数FS值平均降低7.2%，EF值平均降低10.2%，具有统计学意义（p＜0.001），心包积血、胸腔积血及肋骨骨折的超声诊断结果与尸体解剖结果比对，Kappa值＞0.75，诊断结果一致性较好，死后有肺挫裂伤者可探及气胸声像图。结论：超声可对胸部撞击损伤后进行评估，对心包及胸腔积血和肋骨骨折较为敏感，在尸体检验中有一定的应用价值。 |
| 关键词: 超声 无创解剖 交通事故 |
| DOI： |
| 投稿时间：2019-01-05修订日期：2019-01-05 |
| 基金项目:国家自然科学基金资助项目（８１２７１５８６） |
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| Preliminary exploration of chest ultrasound autopsy |
| Cheng Wei,litao |
| (Department of Ultrasound,Daping Hospital,Army Medical University) |
| Abstract: |
| Objective: To investigate the value of ultrasonography in cadaveric necropsy using the animal models. Method: Chest blunt trauma was stimulated in healthy 16 New Zealand rabbits through striking precordia using a BIM-I vertical bioimpacter equipped with 850g，40mm diameter steel rods. The impact center was located in the anterior region between the fourth and the fifth intercostal space. The left ventricular wall thickness, left ventricular hemodynamics, rib fracture, pericardial and pleural effusion as well as pneumothorax were evaluated using ultrasound immediately in animals temporarily surviving after striking. was used to assess cardiac hemodynamics and pericardial effusion. Surviving animals were executed with excessive anesthetic followed by autopsy. The findings of autopsy were compared with results from the ultrasonography. Result: The average thickening of the interventricular septum and the posterior wall of the left ventricle was increased by 1.21 mm and 1.13 mm respectively in animals temporarily surviving after striking, both of which had statistical significance (P<0.001). The FS values of left ventricular ejection fraction and EF values were both significantly decreased by 7.2% and 10.2% respectively (P<0.001). The diagnostic results for pericardial hemorrhage, pleural hemorrhage and rib fracture evaluated by Ultrasound was consistent with those from autopsy results(kappa>0.75). Pulmonary contusion and laceration were detected through pneumothorax sonogram in the died animals. Conclusion: Ultrasound can be used to evaluate chest impact injury. Particularly, ultrasound is a sensitive method to determine pericardium, pleural hemorrhage and rib fracture. Therefore, it has somewhat application value in autopsy. |
| Key words: Ultrasound,Noninvasive Anatomy,Traffic Accident |
