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目的 :探讨淋巴滞留性脑水肿的病理特点。方法 :采用阻断大鼠脑淋巴引流的方法 ,建立淋巴滞留性脑水肿模型 ,从术后不同时间取脑标本 ,光镜及透射电镜下观察海马CAI区锥体细胞层神经元的病理变化。结果 :自术后第二天可见脑组织水肿 ,红细胞溢出及吞噬细胞浸润 ,小血管壁外膜及VirchowRobin间隙增宽 ,内含大量水肿液 ,海马CAI区正常神经元数量明显下降 ,且排列及不整齐 ,细胞皱缩 ,核固缩、深染 ,核染色质聚集 ,核周囊膨大 ,胶质细胞增生。上述变化以术后 5天最显著。结论 :脑淋巴引流阻断 ,可以导致淋巴滞留性脑水肿 ,海马CA1区出现迟发性神经元死亡是其主要病理改变。
Objective: To investigate the pathological features of lymphatic retention brain edema. Methods: The models of lymphatic drainage induced by cerebral lymphatic drainage in rats were established. The pathological changes of neurons in hippocampal CA1 pyramidal cells were observed under light microscope and transmission electron microscope at different time points. Results: Edema of brain tissue, infiltration of erythrocytes and phagocytic cells were observed on the second day after operation. The gap between the outer wall of small blood vessel and VirchowRobin was broadened. A large amount of edema fluid was contained. The number of normal neurons in CAI of hippocampus decreased significantly Irregular, cell shrinkage, nuclear pyknosis, deep staining, nuclear chromatin, perinuclear cyst enlargement, glial cell proliferation. The above changes were the most significant after 5 days. Conclusion: The blockade of cerebral lymphatic drainage can lead to lymphatic retention brain edema. The occurrence of delayed neuronal death in CA1 area of hippocampus is the main pathological change.