伤灶局部亚低温及伤灶局部引流治疗大鼠创伤性脑损伤  

Effects of local hypothermia and drainage on traumatic brain injury in SD rats

作　　者：罗超[1] 刘运生[1] 彭形[2] 赵贤军[1] 李玉斌[1] 徐立新[1] 

机构地区：[1]中南大学湘雅医学院湘雅医院神经外科,湖南长沙410008 [2]重庆市第一人民医院脑外科,重庆400011

出　　处：《创伤外科杂志》2006年第4期340-343,共4页Journal of Traumatic Surgery

摘　　要：目的观察伤灶局部引流及伤灶局部亚低温联合治疗对SD大鼠创伤性脑损伤后脑水含量、Na+含量、血脑屏障的变化,探讨其对创伤性脑损伤的治疗作用及可能机制。方法实验动物随机分成5组:S组为假手术组;M组为脑外伤模型组;LH组为伤灶局部亚低温治疗组;LD组为伤灶局部引流组;LDH组为伤灶局部引流+伤灶局部亚低温联合治疗组。采用干湿重法测伤灶脑组织含水量,原子吸收火焰分光光度法测Na+含量,伊文思蓝检测血脑屏障开放情况。结果(1)脑组织水含量:LH、LD、LDH组伤灶区脑组织含水量分别低于M组(P<0.05);LDH组脑组织水含量低于LD组和LH组(P<0.05)。(2)钠含量:钠离子变化与含水量变化一致,LH组、LD组、LDH组伤灶区脑组织钠离子含量分别低于M组(P<0.05);LDH组钠含量低于LD组和LH组(P<0.05)。(3)EB含量:LH组、LD组、LDH组伤灶区脑组织EB含量分别低于M组(P<0.05);LDH组EB含量低于LD组和LH组(P<0.05)。(4)LD、LDH组引流量分别为(0.2308±0.0356)g、(0.3456±0.0692)g。结论伤灶局部亚低温、伤灶局部引流或二者联合治疗均对创伤性脑损伤有治疗作用,但联合治疗效果优于单独治疗。其治疗效果可能与直接引流出水肿液、减轻脑水肿,促进被破坏血脑屏障的早期修复等有关。Objective To investigate the effect of local hypothermia and drainage on traumatic brain injury in SD rats and its mechanism. Methods Feeney＇s model was used to produce traumatic brain injury in SD rats. After half an hour, both local hypothermia group and the group of local hypothermia combined with drainage received local brain hypothermia with 25℃ circulating water except for the model group, local drainage group and sham operation group. The injured rats were put to death according to the corresponding time. Results Water content of local hypothermia group,local drainage group and the local hypothermia combined with drainage group was markedly less than that of model group （ P 〈 0.05 ）. The change of concentration of brain sodium coincided with that of water content （ P 〈 0.05 ）. EB dye content in the brain tissue of local hypothermia group, focus drainage group and the local hypothermia combined with drainage group was less than those of the model group （ P 〈 0.05 ）. Conclusion The treatment of local hypothermia, local drainage and the combined local hypothermia ＋ local drainage showed great effect on traumatic brain edema, which may be resulted from a decreasing brain edema and a blood - brain barrier permeability defect.

关 键 词：颅脑损伤 引流 亚低温 

分 类 号：R651.1[医药卫生—外科学]