静脉输注氟碳化合物乳剂治疗重型颅脑损伤的实验研究  

Intravenous administration of perflubron emulsion for experimental severe traumatic brain injury

作　　者：郭京[1] 黄辉[2] 付学忠[2] 高超[2] 

机构地区：[1]中日友好医院神经外科,100029 [2]北京铁路总医院

出　　处：《中华神经外科杂志》2000年第6期371-374,共4页Chinese Journal of Neurosurgery

摘　　要：目的　观察静脉输注氟碳化合物乳剂能否减轻外伤后继发性脑缺血损害。方法　杂种狗 16条 ,自由落体法制作重型颅脑损伤模型 ,致伤后实验组立即静脉输注氟碳化合物乳剂 1 35g/kg ,以后每 4小时追加 0 6 7g/kg ,对照组静注生理盐水。连续监测动物颅内压 48小时 ,处死后行病理学研究。结果　对照组死亡率 30 % ,实验组无死亡。致伤后 2 4小时实验组的颅内压显著低于对照组 ,病理证实在距出血灶距离相同的部位 ,实验组的正常神经元数量显著多于对照组。在距出血灶 1cm的部位 ,坏死神经元的数量明显少于对照组。结论　氟碳化合物乳剂确可增强动物对高颅压的耐受性 ,降低死亡率 ,使升高的颅内压较快回降 。Objective To evaluate the effectiveness of intravenous administration of perflubron emulsion for severe traumatic brain injury.Methods Sixteen mongrel dogs, weight 21±6kg, were divided into a control group (10 dogs) and an experimental group (6 dogs). The brain injury was made by a free fall weight strike on frontal parietal lobe through a bone window in anaesthetized dogs. The PFC emulsion was given intravenously to the experimental group (1 35 g/kg immediately after brain injury and 0 67 g/kg every 4 hours for three doses). ICP was measured continuously for 48 hours. The dogs were euthanized, and then histopathology studies were made. The necrotic and normal neurons were counted at 1cm, 2cm, 3cm distance from the traumatic lesion respectively.Results The mortality rate was 30% in control group vs 0% in experimental group. The mean ICP at 24 hours after injury in the 6 survivals in control group was 37 6 mmHg, significantly higher than 18 6 mmHG in the 6 dogs in experimental group (P<0 01). Quantified histopathology study by a computer assisted multimedia pathological image analysis system showed more surviving neurons (5 1 vs. 1.1, P<0 01) and less dead neurons (2 6 vs. 5 0, P<0 05) at 1cm from the traumatic lesion in the experimental group than in control group. Conclusions Intravenous injection of PFC has a protective effect on the neurons near the traumatic brain injury lesion. It can increase the dogs tolerance to the high ICP and decrease the mortality rate after severe experimental TBI. The high ICP return to a lower level faster in experimental group than in control group.

关 键 词：氟碳化合物 颅内压 脑缺血 脑损伤 

分 类 号：R651.150.5[医药卫生—外科学]