临床与实验病理学杂志2012，Vol.28Issue(5)：506-509,4.
人脾破裂损伤时间推断的法医病理学观察
Forensic pathology study of wound age estimation in human spleen rupture
摘要
Abstract
Purpose To research the changes of spleen morphological characteristics,SMA-postive cells,hemosiderin and macrophages in different stages after spleen rupture and to provide evidences for wound age estimation in human spleen rupture. Method 69 cases of splenectomy due to abdominal injury were included, According to its survival time after the rupture of spleen ,the injury groups is divided into eight groups: 0~6 h,7 ~ 12 h,13~24 h,25~48 h,49~72 h,73 h~7 d,8~14 d, > 14 d. The morphological changes were studied using HE staining; changes of the number of SMA-positive cells around the bleeding area were observed using immunohis-tochemistry staining; the variation of haemosiderin around the bleeding area was observed using Prussian blue staining. Results ( 1 ) Around the edge of wound tissue, fibrin exudated and a small amount of neutrophils infiltrated in 6 h groups. ( 2 ) A lot of fibrin exuda-ted and a large number of neutrophils infiltrated in 7~12 h groups. ( 3 ) A small amount of SMA-positive cells scattered around the edge of the wound tissue in 13~24 h groups. ( 4 ) More SMA-positive cells distributed in network around the bleeding area in 25 - 48 h groups. ( 5 ) A large number of SMA-positive cells growed radially into the bleeding area, the difference of each group was statistically significant ( P <0. 05 ). ( 6 ) The granulation tissue generated in 73 h ~7 d groups and 8 ~14 d groups. ( 7 ) The formation of scar tissue appeared after 14 day. ( 8 ) A spot of hemosiderin deposited in the normal spleen tissue,the difference of hemosiderin with diffferent injury time was statistically significant(P < 0. 05 ). Conclusions Spleen morphological characteristics around the bleeding area can used to be main evidences for wound age estimation of human splenic rupture. Fibrin exudation, neutrophils infiltration, SMA-positive cells and its characteristic of distribution, the formation of the granulation tissue and scar tissue can used to be effective evidences for wound age estimation. Hemosiderin is unreliable to wound age estimation of human splenic rupture.关键词
脾破裂/损伤时间/平滑肌肌动蛋白/含铁血黄素/法医病理学Key words
splenic rupture/wound age estimation/SMA/hemosiderin/forensic pathology分类
医药卫生引用本文复制引用
赵元峰,孟刚,陈林..人脾破裂损伤时间推断的法医病理学观察[J].临床与实验病理学杂志,2012,28(5):506-509,4.基金项目
公安部2011年度科技创新项目(2011YYCXAHST049) （2011YYCXAHST049）
