摘要
目的通过观察不同灌注压(CPP)水平对实验性脑创伤早期脑水肿的影响作用来选择适宜的CPP水平,为临床脑创伤治疗提供参考。方法实验用兔30只,随机分为对照组(无颅脑损伤),高CPP组(90～110mmHg),中CPP组(70～80mmHg),低CPP组(60～70mmHg),和极低CPP组(35～45mmHg)5组,每组6只。对照组不予损伤,其余各组均给予(1100±100)N的撞击力致减速性脑损伤(重伤水平)。伤后80min静脉给予升压药或降压药物调控血压使CPP达到设计要求。伤后6h测脑含水量。结果所有颅脑损伤动物均出现了明显的脑损伤生理反应和病理改变,颅内压(ICP)均明显增高(P<0.001)。脑含水量为:对照组,78.18%±0.32%;高CPP组,81.35%±1.02%;中CPP组,80.27%±0.48%;低CPP组80.31%±0.70%;极低CPP组,81.19%±0.74%。与对照组比较损伤组脑含水量均增加(P<0.001)。高CPP和极低CPP两组脑含水量分别较中、低CPP组增高(P<0.05)。结论兔脑创伤后维持CPP在60～80mmHg之间的中低水平,脑水肿轻;CPP降至50mmHg以下和升至90mmHg以上均加重脑水肿。
Objective To investigate the influence of cerebral perfusion pressure (CPP) on the development of traumatic brain edema in rabbits injured by deceleration. Methods 30 rabbits were divided into 5 group: group1: Control (no head injury); group 2: CPP 90~110 mmHg; group3: CPP 70~80mmHg; group4:CPP 60~70 mmHg; and group5:CPP 35~45 mmHg, each consisting of 6 rabbits. The severe head injury of deceleration in group 2 to 5 was produced by application of impact force of (1100±100)N .The CPP control was achieved by regulating blood pressure with vasopressors and vasodilator at 80 minutes postimpact. The intracranial pressure (ICP) during the period of 1 to 6 hours postinjury and the water content of brain at 6th hour after injury were investigated. Results The physiological responses of head injury, raised ICP, increase of water content of brain , traumatic subarachnoid hemorrhage, and brain contusion were noted in all of the head-injured animals .The water content of brain in group 5(81.19%±0.74%) and group 2 (81.35%±1.02%)increased more than that in group 3 (80.27%±0.48%)and group 4 (80.31%±0.70%)(P<0.05). Conclusion there is the least brain edema at 6 hour postinjury in the severely head-injured rabbits of the CPP maintained between 60mmHg and 80mmHg. Both maintaining CPP above 90mmHg by raising blood pressure and decreasing CPP to 50mmHg or less promote traumatic brain edema.
出处
《中华神经外科杂志》
CSCD
北大核心
2005年第4期208-210,共3页
Chinese Journal of Neurosurgery
