选择性超深低温断血流对恒河猴脑干形态及功能的影响  

Effect of blocking the blood flow under selective ultraprofound hypothermia on the morphology and function of brain stem of the macaque

作　　者：周杰[1] 高永军[2] 姜涛[3] 蒲军[2] 江基尧[4] 徐蔚[2] 

机构地区：[1]中国中医科学院望京医院神经外科,北京100102 [2]昆明医学院第二附属医院神经外科,云南昆明650101 [3]浙江中医药大学附属第一医院神经外科,浙江杭州310018 [4]上海第二医科大学附属仁济医院神经外科,上海200001

出　　处：《新乡医学院学报》2013年第3期165-167,171,共4页Journal of Xinxiang Medical University

基　　金：云南省自然科学基金重点项目(编号:2003C0010Z)

摘　　要：目的研究选择性超深低温(14.3～16.0℃)断血流对恒河猴脑干形态及功能的影响。方法成年健康恒河猴6只,分为2血管阻断冷灌注组(n=4)和等温灌注组(n=2)。建立闭胸式脑局部体外循环。2血管阻断冷灌注组经右侧颈内动脉灌注4.0℃林格液,同侧颈内静脉回流,降低脑温至14.3～16.0℃,维持60 min后恢复脑血流,实验动物自然复苏。等温灌注组用相同方法灌注38.0℃林格液。手术中监测血流动力学指标变化,术后行神经功能缺失评分,取动物脑干行光学显微镜和电镜检查。结果 2血管阻断冷灌注组术中、术后血流动力学稳定,灌注60 min后安全复苏并长期存活,术后神经功能评分正常,脑干形态和组织结构无明显异常;等温灌注组于灌注60 min后均未能安全复苏,全部死亡,脑干形态和组织结构有不同程度异常。结论选择性超深低温断血流技术可明显提高猴脑干对缺血缺氧的耐受性,延长血流阻断时间,为临床应用选择性超深低温技术提供了理论依据。Objective To study the effect of blocking the blood flow under selective ultraprofound hypothermia（14.3-16.0 ℃）on the morphology and function of brain stem of the macaque.Methods Six adult healthy macaque were divided into two-vessel occlusion cold perfusion group（n=4）and identical temperature perfusion group（n=2）.Brain local extracorporeal circulation was established.Two-vessel occlusion cold perfusion group was perfused of 4.0 ℃ Ringer′s solution through right internal carotid artery and reflowed through homolateral internal jugular vein.Brain temperature was kept in 14.3-16.0 ℃ for 60 minutes,then brain blood flow was recovered and the macaque came back naturally.Identical temperature perfusion group was perfused of 38 ℃ Ringer′s solution with the same method.The hemodynamic parameters were observed during the operation,neurological function deficient score was evaluated after operation.The brain stem was taken and examined by optical microscopy and electron microscopy.Results The hemodynamic parameters of two-vessel occupation cold perfusion group were stable during the operation,and all macaque recovered and lived up for ever after perfusion for 60 minutes.The neurological function scores were normal and the morphology and function of brain stem were non apparent abnormality.Identical temperature perfusion group was not resuscitated and all macaque died after perfusion for 60 minutes with abnormal morphology and function of brain stem to some extent.Conclusion Selective ultraprofound hypothermia and blood flow occlusion can increase the toleration of brain to ischemia and hypoxia and prolong the time of blood flow occlusion,and it provides a theoretical basis for clinical application of selective ultraprofound hypothermia.

关 键 词：猴 超深低温 脑干 形态学 

分 类 号：R742[医药卫生—神经病学与精神病学]