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左侧膈肌穿孔性损伤扩展 30%的自然演变及愈合的解剖病理学特征。实验研究。

Natural evolution of perforating wounds of 30% extension of the left diaphragm and the anatomopathological characteristics of its healing. Experimental Study.

机构信息

- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Cirurgia - São Paulo - SP - Brasil.

- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Departamento de Ciências Patológicas - São Paulo - SP - Brasil.

出版信息

Rev Col Bras Cir. 2022 Jul 1;49:e20223162. doi: 10.1590/0100-6991e-20223162-en. eCollection 2022.

Abstract

INTRODUCTION

diaphragmatic injury is a challenge for surgeons. It is an injury that can be isolated. It is frequent in penetrating thoracoabdominal trauma. It represents a diagnostic challenge and the ideal approach is not yet well established. The occurrence of spontaneous healing of these injuries is still much discussed and even more, if it does, what is the healing mechanism?

OBJECTIVE

to macroscopically and histologically evaluate the natural evolution of perforation and cutting wounds equivalent to 30% of the left diaphragm.

METHOD

50 specimens of rats underwent a surgical procedure and, after 30 days, were euthanized and those that presented scar tissue in the diaphragm, the samples were submitted to histopathological study, using the hematoxylin and eosin stains, Massons trichrome and Picrosirius to assess the presence of collagen or muscle fibers (hyperplasia) in the scar.

RESULTS

it was found that healing occurred in diaphragmatic injuries in 90% of rats. We also observed the presence of fibrosis in all analyzed samples.

CONCLUSION

Spontaneous healing occurred in most diaphragmatic injuries and the inflammatory reaction represented by the presence of fibrosis and collagen deposition was observed in all our samples. Muscle fiber hyperplasia did not occur.

摘要

引言

膈肌损伤对外科医生来说是一个挑战。它是一种可以孤立存在的损伤。它在穿透性胸腹创伤中很常见。它代表了一个诊断上的挑战,而理想的方法尚未得到很好的建立。这些损伤的自发愈合的发生仍有很多争议,更重要的是,如果确实发生了,愈合机制是什么?

目的

宏观和组织学评估相当于左膈肌 30%的穿孔和切割伤的自然演变。

方法

50 只大鼠标本接受了手术,30 天后安乐死,那些在膈肌有疤痕组织的标本,进行组织病理学研究,使用苏木精和伊红染色、Massons 三色和Picrosirius 染色,以评估疤痕中胶原或肌肉纤维(增生)的存在。

结果

发现 90%的大鼠膈肌损伤有愈合。我们还观察到所有分析的样本中都存在纤维化。

结论

大多数膈肌损伤都发生了自发性愈合,在我们所有的样本中都观察到了以纤维化和胶原沉积为特征的炎症反应。没有发生肌肉纤维增生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0b6/10578814/a193ec35414f/rcbc-49-e20223162-g001.jpg

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