摘要:目的:探討5·12汶川8.0級(jí)地震中顱面部外傷的影像學(xué)表現(xiàn)特點(diǎn)。方法: 回顧性分析自2008年5月12~31日因地震顱面部外傷在我院行CT、MRI檢查的傷員251例,其中CT檢查248例,MRI檢查16例。結(jié)果:放射檢查陽(yáng)性162例,陽(yáng)性率為64.54%,以40～49歲年齡組最多,為53例,其中男性41例。在放射檢查陽(yáng)性中,多發(fā)傷112例(約69.13%),多類(lèi)型顱面部外傷同時(shí)并存103例(約63.58%)。主要損傷發(fā)生率依次為軟組織損傷(35.50%),骨折(22.94%),腦挫裂傷(21.21%),硬膜下及硬膜外血腫(10.40%),其它(共約9.92%)。結(jié)論: 地震造成顱面部外傷人群主要為40～49歲中年男性,多發(fā)傷、多類(lèi)型顱面部外傷多見(jiàn),并以軟組織損傷、骨折、腦挫裂傷、硬膜下及硬膜外血腫較常見(jiàn)。Abstract: Objective: To describe the imaging features of head and face injured patients after the Wenchuan earthquake. Methods: The radiological information of 251 victims who were suspicious of head and face injury and underwent CT or MRI examinations from 12 May to 31 May 2008 was analysed retrospectively. There were 248 and 16 cases underwent CT or MRI examinations respectively. Results: One hundred and sixtytwo cases(64.54% )were positive. There were 53 cases in the 4049 years old age group, of which 41 were male. In patients with positive findings, 112 cases (about 63.58%) were comprised of several types of head and face injury. The incidence of the main injury type included: soft tissue injury (35.50%), fracture (22.94%), cerebral contusion (21.21%), subdural and epidural hematoma (12.40%), others (9.92%). Conclusions: The males with head and face injury in 4049 years old group were the major injured people in this earthquake. Head and face injury accompanied by multiple system injuries, the existence of several types of head and face injury at the same time were common. Among all the injury types, soft tissue injury, fracture, contusion, subdural and epidural hematoma were relatively commom.
目的 觀察應(yīng)用液壓沖擊顱腦損傷儀（FPI）能否成功建立大鼠外傷性視神經(jīng)損傷動(dòng)物模型。方法 成年雌性Wister大鼠71只，隨機(jī)選取5只為正常對(duì)照組，其余66只為模型組。模型組再隨機(jī)分為3組。第1組8只大鼠，分別于損傷前、損傷后1、3 d、1、2、4、6、8周行雙眼閃光視覺(jué)誘發(fā)電位（F-VEP）及視神經(jīng)核磁共振成像（MRI）檢查；第2組56只大鼠，隨機(jī)分成7個(gè)亞組，每個(gè)亞組8只大鼠，分別于損傷后1、3 d、1、2、4、6、8周行視網(wǎng)膜組織病理學(xué)及末端脫氧核苷酸移換酶介導(dǎo)的dUTP缺口末端標(biāo)記測(cè)定法（TUNEL）檢測(cè)；第3組2只大鼠，分別于損傷后4、8周行視神經(jīng)透射電子顯微鏡檢測(cè)。根據(jù)打擊力量不同，將損傷眼分為輕、重2組。重傷組打擊錘以25deg;的預(yù)定角度打擊視神經(jīng)，平均打擊力量（699.14 plusmn;60.79） kPa，輕傷組以15deg;的預(yù)定角度打擊，平均打擊力量（243.18plusmn;20.26） kPa。每只大鼠右眼為重傷組，左眼為輕傷組。結(jié)果 重傷組損傷后1d主波潛伏期延長(zhǎng)，與正常對(duì)照組比較,差異有統(tǒng)計(jì)學(xué)意義(t=2.06,P＜0.05);F-VEP振幅在損傷后2周內(nèi)逐漸降低,2周后趨于穩(wěn)定(F=1.98,P＞0.05)。輕傷組損傷后1 d主波潛伏期延長(zhǎng)，與正常對(duì)照組比較，差異有統(tǒng)計(jì)學(xué)意義（t=2.19,P＜0.05）；振幅在損傷后4周內(nèi)逐漸降低，4周后趨于穩(wěn)定（F=1.62,P＞0.05）。MRI檢查顯示，損傷后1 d視神經(jīng)高信號(hào)，損傷后8周仍較明顯。組織病理學(xué)檢查發(fā)現(xiàn)，損傷后1 d視網(wǎng)膜神經(jīng)節(jié)細(xì)胞層（GCL）可見(jiàn)毛細(xì)血管破裂出血；損傷后4周GCL內(nèi)可見(jiàn)空化的視網(wǎng)膜神經(jīng)節(jié)細(xì)胞。損傷后3 d視網(wǎng)膜各層均出現(xiàn)凋亡陽(yáng)性細(xì)胞；TUNEL染色發(fā)現(xiàn)損傷后1、2周凋亡陽(yáng)性細(xì)胞明顯增多。結(jié)論 應(yīng)用FPI能成功建立大鼠外傷性視神經(jīng)損傷模型。