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医学论文范文:外伤后细菌性致死性肉芽肿的透射电镜观察
关键词: 肉芽肿;显微镜检查，电子;细菌，氧菌
摘 要:目的 外伤后细菌性致死性肉芽肿是一种尚未被认识的新疾病，近20a来在我国多个地区已发现20余例，无一存活.本研究应用透射电镜寻找病原体，为该病的诊断和治疗提供线索. 方法 以透射电镜观察2例外伤后细菌性致死性肉芽肿的活检组织，寻找该病的病原. 结果 病变组织内主要为组织细胞、多核巨细胞，细胞内有大量溶酶体样结构，部分溶酶体样结构具有“杆菌”形态，另见少数球菌.根据电镜下的发现成功分离出1种严格的厌氧性细菌，初步确定为放线菌，并根据细菌药敏结果救活了1例患者. 结论 对于怀疑由病原体所致的疾患，电镜下发现损害中的病原体是最具说服力的证据，本病的发现和命名，电镜发挥了关键作用.
Observation of fatal bacteria granuloma after trau┐ma on transmission electron microscopy
GAO Tian-Wen，LI Chun-Ying，LIAO Wen-Jun，LIU Jian
Center of Dermatology&Venereology of Chinese PLA，Xijing Hospital，Department of Electron Mi-croscopy，Faculty of Preclinical Medicine，Fourth Military Medical University，Xi'an710033，China
Keywords:granuloma;microscopy，electron;bacteria，anaerobic
Abstract:AIM Fatal Bacteria Granuloma after Trauma is a new kind of disease that has not been recognized.More than20cases of the disease have been noticed in China during the past20years.No patient had been saved till recently.The aim was to probe into the pathogen of the disease and save the patients'life.METHODS Tissues from the lesion of pa-tients were observed through electron microscopy.RESULTS There were a lot of histocytes and multinuclear giant cells in the lesions.A great quantity of lysosome-like structure was observed in multinuclear giant cells and histocytes.A part of lysosome-like structure was supposed as bacteria.Besides coccus，a kind of anaerobic actinomycetes was isolated with anaerobic culture according to the finding of electron mi-croscopy.The patient was saved on the base of the result of medicine sensitive test of bacteria.CONCLUSION It is the most convinced proof to find pathogen on electron microscopy for the diseases suspected due to pathogens.The electron mi-croscopy plays a key role in the finding and naming of the dis-ease.医.学全.在.线www.med126.com
引言
一种于外伤愈合后形成的皮肤肉芽肿系尚未被认识的新疾病，近20a来在我国多个地区已发现20余例，其组织病理、临床过程基本相同.由于其临床的基本改变为结节，组织病理基本上为组织细胞浸润，故按结节病进行治疗，患者全部在1.5～4a内死亡.1996年我们诊治第1例，通过透射电镜发现其病原为细菌，从形态看有球菌及“杆菌”.细菌培养确定了其中的球菌为表皮葡萄球菌，但3次厌氧及需氧培养均未能分离出电镜下所见的“杆菌”.使用对表皮葡萄球菌敏感的抗生素治疗未能挽救患者的生命.通过认真分析上例中杆菌分离失败及其他学者均未能分离出细菌的原因，认为“杆菌”可能为严格厌氧菌[1] .依据上述分析和思路，1999年在另1例患者皮损中分离出病原菌，并依据分离出的细菌药敏结果成功挽救了患者.电镜观察在本病的确定中起了关键作用，我们特予叙述和讨论.
