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图示纤维素性心包炎。许多淡红色弯弯曲曲的呈丝线状的物质为纤维蛋白,在心外膜表面一直延伸到黄*色分泌液中。这类心包炎是肾衰尿毒症、心肌梗死以及急性风湿性心脏炎的表现。

This diagram depicts the appearance of a fibrinous pericarditis. The red-pink squiggly lines extending from the epicardial surface into the yellow fluid represent the strands of fibrin. This type of pericarditis is typical of uremia with renal failure, underlying myocardial infarction, and acute rheumatic carditis.

开胸可见粘连性心包炎患者心脏表面。从心外膜直到心包囊可见纤维素性渗出物,这是纤维素性心包炎的典型表现。

A window of adherent pericardium has been opened to reveal the surface of the heart. There are thin strands of fibrinous exudate that extend from the epicardial surface to the pericarial sac. This is typical for a fibrinous pericarditis.

纤维素性心包炎。由于红褐色的纤维蛋白沉积,心包表面由光滑发光变得粗糙。

This is an example of a fibrinous pericarditis. The surface appears roughened from the normal glistening appearance by the strands of pink-tan fibrin.

心外膜表面可见粗糙的纤维蛋白渗出物。也是纤维素性心包炎。称为绒毛心。听诊时出现心包摩擦音,这是因为沉积在心外膜和心包的纤维素相互摩擦所致。

The epicardial surface of the heart shows a shaggy fibrinous exudate. This is another example of fibrinous pericarditis. This appearance has often been called a "bread and butter" pericarditis, but you would have to drop your buttered bread on the carpet to really get this effect. The fibrin often results in the the finding on physical examination of a "friction rub" as the strands of fibrin on epicardium and pericardium rub against each other.

镜下见心包的表面沉积的淡红纤维素向外延伸。并有炎症存在。纤维素可以被机化、吸收,也会粘连在一起。

Microscopically, the pericardial surface here shows strands of pink fibrin extending outward. There is underlying inflammation. Eventually, the fibrin can be organized and cleared, though sometimes adhesions may remain.

图示心包炎时不但有纤维素形成,而且还有出血。因此,被称作“出血性心包炎”。但是它仅为纤维素性心包炎合并出血。在心包腔里没有炎症仅有出血,称作心包积血。

The pericarditis here not only has fibrin, but also hemorrhage. Thus, this is called a "hemorrhagic pericarditis". It is really just fibrinous pericarditis with hemorrhage. Without inflammation, blood in the pericardial sac would be called "hemopericardium".

出血性心包炎的心脏表面呈红色粗糙状。出血性心包炎最可能合并转移性肿瘤和肺结核(TB)。TB还可以导致肉芽肿性心包炎,进而可能钙化和产生缩窄性心包炎。

The surface of the heart with hemorrhagic pericarditis demonstrates a roughened and red appearance. Hemorrhagic pericarditis is most likely to occur with metastatic tumor and with tuberculosis (TB). TB can also lead to a granulomatous pericarditis that may calcify and produce a "constrictive" pericarditis.

化脓性心包炎。注意黄*色的分泌液淤积在已被切开的心包腔内下部。

This is a purulent pericarditis. Note the yellowish exudate that has pooled in the lower pericardial sac seen been opened here.

虽然心外膜的表面平滑并反光,但是还存在着小而散在的黄*色微脓肿。此为放大照片。

The epicardial surface of the heart is smooth and glistening, but there are small scattered pinpoint yellowish microabscesses. (Higher magnification in next photo).

本例为前一张照片的放大图,可见心外膜的表面有小而黄*色的针尖状微脓肿。微脓肿可能在脓毒败血症患者中发生。他们也可能表现为冠脉外的栓塞,引起栓塞的栓子来自感染性心内膜炎的赘生物。

This magnification of the preceding photograph shows the small yellowish pinpoint microabscesses on the epicardial surface. Microabscesses may appear in persons who are septic. They may also represent emboli from an infective endocarditis in which small portions of a vegetation have embolized out the coronary arteries.


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