生理盐水冲洗伤口对创伤性脑损伤合并海水浸泡大鼠的影响  

Effects of wound irrigation with normal saline on rats with traumatic brain injury combined with seawater immersion

作　　者：杨洋[1] 俞霞 侯鹏伟 陈力 徐永君 魏梁锋 王守森 YANG Yang;YU Xia;HOU Pengwei;CHEN Li;XU Yongjun;WEI Liangfeng;WANG Shousen(Department of Neurosurgery,Fuzong Teaching Hospital(the 900th Hospital),Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350025,China;Fuqing City Hospital Affiliated to Fujian Medical University,Fuqing,Fujian 350300,China;Department of Neurosurgery,Fuzong Clinical Medical college of Fujian Medical University(the 900th Hospital),Fuzhou,Fujian 350025,China)

机构地区：[1]福建中医药大学福总教学医院(第九○○医院)神经外科,福建福州350025 [2]福建医科大学附属福清市医院,福建福清350300 [3]福建医科大学福总临床医学院(第九○○医院)神经外科,福建福州350025

出　　处：《中华神经外科疾病研究杂志》2024年第1期6-10,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：联勤医学重点专科(神经外科)项目;联勤保障部队第九○○医院指令性项目战创伤救治专项(2022ZL01,2022ZL03);中国博士后基金面上项目(2021M693955)。

摘　　要：目的建立创伤性脑损伤合并海水浸泡(TBI+SI)大鼠模型,采用生理盐水对TBI+SI大鼠进行冲洗,以稀释海水的高渗透性和高碱性,并评估其治疗效果.方法健康成年雄性大鼠48只,按照随机数字表法分为假手术(Sham)组、创伤性脑损伤(TBI)组、创伤性脑损伤合并海水浸泡伤(TBI+SI)组和生理盐水冲洗(TBI+SI-NS)组,每组12只.采用控制性皮质损伤方法构建TBI模型.Sham组头皮切开后磨出直径3.5 mm骨窗,暴露硬脑膜,但不予处理;TBI大鼠头皮切开后磨出3.5 mm骨窗,实施控制性皮质损伤打击;TBI+SI组行TBI术后,采用人工海水浸泡创伤部位30 min;TBI+SI-NS组在TBI+SI基础上,用无菌生理盐水冲洗25 min.应用干湿重法测定脑组织含水量,ELISA检测脑组织肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)和白介素-1β(IL-1β)的表达量,HE染色观察脑组织病理变化,透射电镜观察神经元细胞线粒体损伤情况.结果与TBI组相比,TBI+SI组脑组织含水量升高(P<0.01),炎性因子TNF-α、IL-6和IL-1β表达上调(P<0.05,P<0.01),损伤部位大脑皮质脑组织病理变化和皮质神经元细胞损伤更加严重(P<0.05).采用生理盐水对TBI大鼠的创伤部位进行冲洗25 min后,脑组织含水量下降(P<0.05),TNF-α、IL-6和IL-1β表达下调,脑组织病理变化和神经元细胞损伤减轻.结论生理盐水冲洗TBI+SI大鼠的创伤部位,缓解了脑组织的进一步损伤,减轻了病理变化和神经元细胞的死亡,其机制可能与生理盐水稀释海水的矿盐成分和降低其高渗透性有关.Objective After the rat model of traumatic brain injury combined with seawater immersion(TBI+SI)was established,normal saline was utilized to wash TBI+SI rats for the sake of diluting high permeability and alkalinity of seawater,ultimately aiming at evaluating therapeutic effect of normal saline.Methods Forty-eight healthy adult male rats were randomly and equally divided into Sham operation(Sham)group,traumatic brain injury(TBI)group,traumatic brain injury combined with seawater immersion(TBI+SI)group and normal saline irrigation(TBI+SI-NS)group,with 12 rats in each group.The TBI model was established by the method of controlled cortical injury.In Sham group,the scalp was cut and the dura mater was then exposed by grinding a 3.5 mm diameter bone window.Noticeably,the dura was unprocessed.In TBI group,rats were subjected to controlled cortical damage after an incision and a 3.5 mm-diameter ground bone window had been made on the scalp.The TBI+SI group received artificial seawater immersion in traumatic sites for 30 min after TBI.The TBI+SI-NS group was rinsed with sterile normal saline for 25 min on the basis of TBI+SI.Water content of the brain was tested via wet and dry weight method.Expression levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)in brain tissue were detected by ELISA.Pathological variation of brain tissue was observed by HE staining.Damage condition of neuronal mitochondria was observed by transmission electron microscope.Results Compared with the TBI group,the TBI+SI group had significantly increased brain water content(P<0.01),up-regulated expression levels of inflammatory factors containing TNF-α,IL-6 and IL-1β(P<0.05,P<0.01).Moreover,pathological changes of brain tissue and damage of neuronal cells in the cerebral cortex at the site of injury were more severe(P<0.05).At 25min after washing the traumatic site of TBI rats with normal saline,not only the water content of brain tissue decreased(P<0.05),but also expression levels of inflammatory factors TNF

关 键 词：创伤性脑损伤 海水浸泡 炎症 生理盐水 伤口冲洗 

分 类 号：R651.1[医药卫生—外科学]