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目的对比观察不同吸收剂量、不同存活时间对极重度骨髓型放射病肺组织病变发生发展的影响。方法分别于病人死亡后从肺脏取材,每个尸检病例从不同部位取材数块,10%甲醛固定,石蜡包埋,病理组织切片,分别行HE和Gimsa染色,光学显微镜观察和分析。结果极重度骨髓型伴轻度肠型放射病尸检病例(107号)肺内主要病变为肺组织大面积坏死伴广泛性曲霉菌感染;另一极重度骨髓型放射病尸检病例(108号)肺内主要病变为广泛性卡氏肺孢子虫感染,虫体充满肺泡腔,肺泡间隔增宽,成纤维细胞活跃增生伴胶原纤维形成。结论放射病抢救治疗过程中肺内容易继发霉菌或卡氏肺孢子虫感染,可能与病人的呼吸衰竭和早期死亡有直接关系;极重度骨髓型放射病人的存活时间超过2个月,早期肺纤维化过程开始启动。
Objective To compare the effects of different absorbed doses and different survival time on the development of pulmonary lesions in patients with very severe bone marrow radiotherapy. Methods The specimens were collected from the lungs after the death of the patients. Each autopsy specimen was taken from different parts of the body, fixed in 10% formalin, embedded in paraffin and sliced in pathological sections. The specimens were stained with HE and Gimsa respectively and observed with optical microscopy. Results Severe myelopathy with mild enterophoretic disease Autopsy cases (No.107) The main lung lesions were extensive necrosis of lung tissue with extensive Aspergillus infection; another extremely severe myeloid autopsy cases (108) were mainly intrapulmonary The lesions were widespread Pneumocystis carinii infection, full of alveolar larval worms, alveolar septum widened, active fibroblasts with collagen fibers. Conclusions The intranasal susceptibility to mold or Pneumocystis carinii infection in the course of salvage radiotherapy may be directly related to the patient’s respiratory failure and early death. The patients with very severe bone marrow radiofrequency have survival time more than 2 months. The early pulmonary fibrosis The process of starting to start.