实验性兔颅脑爆炸伤后高压氧治疗作用的磁共振波谱研究  

MRS research of hyperbaric oxygen therapy in rabbits after explosive brain injury

作　　者：杨艳艳[1] 刘家传[1] 张永明[1] 孙文江[1] 汤宏[1] 黄振山[1] 李兵仓[2] 张良潮[2] 

机构地区：[1]解放军105医院神经外科,合肥230031 [2]第三军医大学大坪医院野战外科研究所,重庆400042

出　　处：《中国微侵袭神经外科杂志》2011年第6期273-276,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：南京军区联勤部卫生部十一五重点基金项目(编号:06Z19)

摘　　要：目的利用磁共振波谱技术（MRS）探讨高压氧治疗对颅脑爆炸伤时脑局部代谢变化的影响。方法新西兰大白兔100只随机分成对照组、创伤组和高压氧治疗组。采用600 mg TNT当量纸雷管在兔脑上方6.5 cm垂直距离爆炸以建立颅脑爆炸伤模型。对照组无损伤,创伤组爆炸伤后不进行任何治疗,高压氧治疗组于伤后行高压氧治疗。观察爆炸伤后各组兔的生理改变,采用MRS计算并分析各组不同时相点乙酰天门冬氨酸（NAA）/肌酸（Cr）、胆碱（Cho）/Cr的比值,分析比较各组脑组织含水量的变化。结果成功复制兔颅脑爆炸伤模型。与对照组相比,创伤组兔NAA/Cr比值伤后24 h明显下降（P〈0.05）,7 d后有所回升,14 d后再次下降（P〈0.05）;高压氧治疗组NAA/Cr比值下降较创伤组延迟,且幅度小。创伤组Cho/Cr比值伤后12 h明显升高,24 h下降,伤后3~14 d逐渐升高;高压氧治疗组Cho/Cr比值较创伤组升高,但7 d后无统计学差异。与对照组比较,创伤组、高压氧治疗组损伤或治疗1 h～7 d后脑组织含水量均明显升高（均P〈0.05）。结论高压氧可改善局部神经元代谢,抑制脑水肿,增强局部胶质细胞增生修复。伤后7 d内干预可能有助于改善预后。Objective To investigate the effect of hyperbaric oxygen（HBO） therapy on local metabolic changes in the brain after explosive brain injury by magnetic resonance spectroscopy（MRS）.Methods A hundred New Zealand white rabbits were divided into the control group,injury group and HBO therapy group randomly.The rabbits were injured by 600 mg TNT equivalent of paper detonators,which exploded at 6.5 cm distance over the rabbit head,as explosive injury model in the injury and HBO therapy groups,and no explosive injury was performed in the control group.The rabbits in HBO therapy group received HBO therapy after explosive injury.The pathophysiological changes of the rabbits were observed after explosive injury in the three groups.Magnetic resonance spectroscopy（MRS） was performed to compute and analyze the ratios of N-acetylaspartate（NAA） to creatine（Cr） and choline（Cho） to Cr in each group at different time points.The changes of the cerebral water content in the three groups were also analyzed and compared statistically.Results The explosive injury model was established successfully.Compared with the control group,the ratio of NAA to Cr in the injury group was decreased markedly 24 d after injury（P0.05）,rose slightly 7 d later,fell again at 14 d（P0.05）.Compared with the injury group,the time when NAA/Cr ratio started decrease delayed in HBO therapy group and the amplitude of the decrease was small.Compared with the control group,the Cho/Cr ratio increased markedly 12 h after injury,decreased at 24 h and rose gradually from 3 to 14 d.The Cho/Cr ratio was higher in HBO therapy than in injury group,but no significant difference existed between them 7 d after injury.The cerebral water content was higher in both the injury and HBO therapy groups than in the control group from 1 h to 7 d after injury or treatment（all P0.05）.Conclusions HBO therapy can improve the metabolism of local neurons,inhibit brain edema and enhance the proliferation and repair of local gliocytes.An intervention within

关 键 词：颅脑损伤 高压氧 磁共振波谱 模型 动物 

分 类 号：R651.15[医药卫生—外科学]