低温生理盐水静脉灌注对局灶性脑缺血兔颅内压的影响  

The effects of intravenous infusion of ice-cold normal saline on the intracranial pressure of rabbits with focal cerebral ischemia

作　　者：李承晏[1] 李涛[1] 毛李征[1] 

机构地区：[1]武汉大学人民医院神经科,武汉430060

出　　处：《中华物理医学与康复杂志》2005年第2期65-67,共3页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：湖北省科委重点攻关项目(No.2001AA307B)

摘　　要：目的探讨低温(4℃)生理盐水静脉灌注对局灶性脑缺血家兔颅内压的影响。方法20只家兔制成大脑中动脉梗死模型后,随机分成对照组和低温生理盐水组(低温组),每组10只,低温组用4℃生理盐水经外周静脉注入,将脑温降至(34.5±0.5)℃,维持24h;对照组注入常温(22.0±1.0)℃的生理盐水;动态观察降温前、后脑温(Tc)、颅内压(ICP)、平均动脉压(MAP)和脑灌注压(CPP)的变化,24h后处死家兔。结果低温组在降温后2h、12h和24hICP分别为(12.5±2.2)、(11.0±2.2)和(10.5±2.0)mmHg,对照组分别为(15.7±2.9)、(18.1±3.1)和(21.3±3.4)mmHg,低温组明显低于对照组(P<0.05)。在降温后2h、12h和24h,低温组CCP分别为(86.3±7.3)、(81.9±3.9)和(80.9±5.1)mmHg,对照组分别为(71.9±3.7)、(71.8±3.5)和(70.4±3.1)mmHg,低温组明显高于对照组(P<0.05)。低温组在降温后2h、12h和24hMAP分别为(98.3±9.5)、(93.0±5.8)和(91.4±7.1)mmHg,对照组分别为(87.6±6.3)、(89.9±6.6)和(91.7±6.0)mmHg,降温后2h、12h低温组明显高于对照组(P<0.05),降温后24h两组间差异无统计学意义(P>0.05)。结论低温(4℃)生理盐水经静脉滴入能降低家兔局灶性脑缺血模型的颅内压,升高平均动脉压和脑灌注压。Objective To study the effects of intravenous ice-cold 0.9% saline (4℃) on the intracranial pressure of rabbits with focal cerebral ischemia. Methods The model of cerebral middle artery occlusion was made in 20 rabbits, who were then randomly divided into two groups: a mild hypothermia group treated with intravenous infusion of ice-cold 0.9% saline (4℃) over 24h and a control group with intravenous infusion of 0.9% saline of the temperature of 22℃. The cerebral temperature (Tc), intracranial pressure (ICP), mean artery pressure (MAP) and cerebral perfusion pressure (CPP) were monitored in all rabbits. Results The ICPs were 12.5±2.2, 11.0±2.2 and ~10.5 ±2.0 mmHg in the 2h, 12h and 24h after mild hypothermia in the mild hypothermia group, and 15.7±2.9, ~18.1 ±3.1 and 21.3±3.4 mmHg in the control group, respectively. The ICPs of the mild hypothermia group were significantly lower than those of the control group (P<0.05). The CCPs were 86.3±7.3, 81.9±3.9 and 80.9±5.1 mmHg at 2h, 12h and 24h after mild hypothermia in the mild hypothermia group, and 71.9±3.7, 71.8±3.5 and 70.4±~3.1 mmHg in the control group, respectively. The ICPs of the mild hypothermia group were significantly higher than those of the control group (P<0.05). The MAPs were 98.3±9.5, 93.0±5.8 and 91.4±7.1 mmHg in the mild hypothermia group, and 87.6±6.3, 89.9±6.6 and 91.7±6.0 mmHg in the control group, respectively. The MAPs of the mild hypothermia group were significantly higher than those of the control group in the 2h, 12h after mild hypothermia, there was no difference between both groups with regard to the MAP at the time point of 24h (P>0.05). Conclusion These results indicated that intravenous infusion of ice-cold 0.9% saline could decrease the ICP and increase CCP and MAP after focal cerebral ischemia.

关 键 词：对照组 生理盐水 颅内压 局灶性脑缺血 低温 脑灌注压 脑温 对局 结论 目的 

分 类 号：R743[医药卫生—神经病学与精神病学] R651[医药卫生—临床医学]