犬颅脑爆震伤模型的建立和甘露醇早期治疗研究  

Establishment of animal model with craniocerebral explosive wound in dogs and observation on early treatment with mannitol

作　　者：张广林[1] 贺世明[1] 张相安 高波[1] 于嘉[1] 王占江[3] 高国栋[1] 

机构地区：[1]第四军医大学唐都医院神经外科 [2]解放军71282部队医院外科 [3]西北核技术研究所

出　　处：《中华神经外科疾病研究杂志》2007年第4期356-358,共3页Chinese Journal of Neurosurgical Disease Research

基　　金：全军"十一五"军事医药卫生指令性课题资助项目(05XJM005)

摘　　要：目的建立颅脑爆震伤动物模型,早期应用甘露醇治疗,探讨脑损伤病理变化及治疗效果。方法杂种犬20只,制作成点爆炸源颅脑爆震伤模型,随机分为:对照组(n=8)及实验组(n=12),实验组静注甘露醇(5ml/kg,1/6h),观察每一组血流变、颅内压、脑组织病理及死亡率。结果犬爆震伤后,红细胞压积、血液粘度、颅内压指标均出现持续升高、血小板则持续下降(P<0.05);与对照组比较,实验组红细胞压积、血液粘度、血小板、颅内压指标明显改善(P<0.01),受伤部位的存活神经元也明显增多(P<0.01),实验组死亡率(2/12)明显低于对照组(6/8)(P<0.05)。结论早期应用甘露醇可改善血液流变特性,改善脑部微循环,降低颅内压,减轻犬爆震伤后神经元的缺血性损害,降低死亡率。Objective To establish animal model with craniocerebral explosive wound in dogs and to observe the pathological alterations and treatment effects by veneclysis 20% mannitol. Methods Twenty dogs were included in a new model of craniecerebral explosive injury and they were randomly divided into control groups （n =8） and experimental groups （n = 12）. Experimental groups were applied by venoclysis 20% mannitol （5 ml/kg, 1/6 h）. Blood rheology, intracranial pressure, pathology, and mortality rate were observed. ResultsIt was found that intracranial pressure, blood viscosity, hematocrit were increased in both groups after cerebral explosive wound, but platelets were decreased in both groups （P 〈 0.05）. Levels of those indexes were improved significantly in experimental groups compared with control groups （ P 〈0. 01 ）. The changes of pathology between experimental and control groups declared that the survival neuron number in experimental groups was more than that in control groups at the same craniecerebral explosive wound position and mortality rate were significantly higher in control groups （ 6/8 ） than that in experimental groups （2/12） （ P 〈 0. 05 ）. Conclusion Early treatment with veneclysis 20% mannitol can improve blood rheological characteristics, ameliorate cerebral micrecirculation, decrease intracranial pressure, reduce neuronal ischemic damage, and decrease the death rate of dogs with craniecerebral explosive wound.

关 键 词：爆震伤 颅脑损伤 甘露醇 早期救治 颅脑损伤 犬 

分 类 号：R651.1[医药卫生—外科学]