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关于休克时的心肌形态变化,以往文献中虽有记载,但多系动物实验研究结果,人体材料观察较少。在克山病研究中,早就发现急重型克山病患者都有心源性休克,病理上以广泛心内膜下心肌坏死为主要改变。关于这种心肌广泛变质性改变与休克之间的因果关系,各研究者的看法尚不一致。有人考虑这种心肌广泛变质性改变并非克山病所固有,而是继发于休克的损伤;也有人认为,此类心肌病变只见于急重型病例,是本型克山病的特征性改变,考虑心肌损伤在先,是引起休克的原因。为了弄清休克时的心肌病变特点,借以说明急重型克山病心肌病变与休克之间的关系,我们对18例非克山病休克尸检材料进行了病理观察分析。
Myocardial morphological changes in shock, although documented in the literature, but more than the Department of Animal Experimental Research results, observed less human material. In Keshan disease research, it has long been found that patients with acute and severe Keshan disease have cardiogenic shock, and pathological changes mainly include extensive myocardial sub-myocardial necrosis. There is a lack of agreement among researchers regarding this causal relationship between extensive deterioration of myocardium and shock. Some people think that this wide range of myocardial deterioration is not inherent Keshan disease, but secondary to shock damage; some people think that such cardiomyopathy seen only in severe cases, Keshan disease is a characteristic change, Consider the first myocardial injury, is the cause of shock. In order to clarify the characteristics of myocardial lesions in shock, in order to illustrate the relationship between acute and severe Keshan disease and myocardial infarction, we conducted 18 cases of non-Keshan disease autopsy material pathological observation and analysis.