硬膜外局部低温与全身低温并发症的对比研究  

Comparative Study on Complications of Epidural Local Hypothermia and Systemic Hypothermia

作　　者：方文华[1] 刘运生[1] 姜交德[1] 

机构地区：[1]中南大学湘雅医院神经外科,湖南长沙410008

出　　处：《现代生物医学进展》2009年第4期690-692,748,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨硬膜外局部低温的并发症情况。方法:SD大鼠随机分为常温对照组(Nor组)、硬膜外局部低温组(LH组)和全身低温组(SH组),LH组以自制降温线圈贴附于一侧硬膜外实施局部低温,SH组以冰袋和酒精全身降温,两组均使脑温降至31.0-32.0℃并持续10小时。实验中观察大鼠寒战反应,监测脑温、肛温及呼吸、心率、血压变化,于降温末取血进行血气分析、电解质、血常规及血液流变学检测。结果:降温后,LH组和SH组脑温均下降到目标温度并维持稳定。降温过程中,SH组寒战发生率为57.1%,且出现心率下降,血小板降低,高切变率全血粘度和血浆粘度增高,LH组未观察到如上变化。结论:硬膜外局部降温可达到与全身降温一样的降温效果,而与全身低温相比,硬膜外局部低温并发症更少。Objective： To investigate the complications of epidural local hypothermia. Methods： SD rats were divided randomly into normal temperature （Nor） group, local hypothermia （LH） group and systemic hypothermia （SH） group. The local and systemic hypothermia were induced by self-made cooling coil and ice bag, alcohol respectively, the brain temperature were reduced to 31.0-32.0℃ for 10 hours. During cooling, the shivering reaction, brain temperature, rectal temperature, respiratory, heart rate and blood pressure of rats were assessed. And the blood gas and electrolyte analysis, blood routine and hemorheology of rats were also detected after cooling. Results： The brain temperature of both LH and SH group dropped to target temperature after cooling. In SH group, the incidence of shivering was 57.1%, the decrease of HR and platelet count were observed, and the increase of whole blood viscosity under high shear and plasma viscosity were also detected during cooling. There were no such changes in LH group. Conclusions： Compared with systemic hypothermia, the epidural cooling can achieve the uniformity effect of brain hypothermia, with little complication.

关 键 词：局部低温 全身低温 并发症 脑保护 

分 类 号：R318.52[医药卫生—生物医学工程] R741.05[医药卫生—基础医学]