新型渗透性敷料对创伤性脑损伤合并海水浸泡伤大鼠的影响  

Effect of new permeable dressing in traumatic brain injury rats with seawater immersion

作　　者：潘振洪 张灏 杨洋[1] 叶丹[1] 徐永君 黄银兴 吴再新 魏梁锋 王守森 Pan Zhenhong;Zhang Hao;Yang yang;Ye Dan;Xu Yongjun;Huang Yinxing;Wei Liangfeng;Wu Zaixin;Wang Shousen(Department of Neurosurgery,Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine/the 900 Hospital of Joint Logistic Support Force,Fuzhou,Fujian 350025,China;Department of Neurosurgery,Fuzong Clinical Medical college of Fujian Medical University/the 900 Hospital of Joint Logistic Support Force,Fuzhou Fujian 350025,China;Department of Military Medical Service,Fuzong Clinical Medical college of Fujian Medical University/the 900 Hospital of Joint Logistic Support Force,Fuzhou Fujian 350025,China)

机构地区：[1]福建中医药大学福总教学医院联勤保障部队900医院神经外科,福建福州300025 [2]福建医科大学福总临床医学院联勤保障部队900医院神经外科,福建福州300025 [3]福建医科大学福总临床医学院联勤保障部队900医院卫勤部,福建福州300025

出　　处：《中国微侵袭神经外科杂志》2023年第12期164-168,共5页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：全军后勤科技重大项目子课题(编号:AHJ14J001);联勤保障部队900医院指令性项目战创伤救治专项(编号:2022ZL01,2022ZL03)。

摘　　要：目的探讨新型渗透性敷料对创伤性脑损伤(traumatic brain injury,TBI)合并海水浸泡伤大鼠的神经保护作用。方法采用甲基丙烯酰化明胶和导电聚吡咯制备水凝胶,同时将生理盐水包裹在水凝胶中制备成新型渗透性敷料用于TBI合并海水浸泡伤大鼠的治疗。36只SD大鼠随机分为假手术组(A组,n=12)、TBI+海水浸泡伤(B组,n=12)和新型渗透性敷料治疗组(C组,n=12)。利用颅脑打击器制备TBI大鼠模型,采用人工海水浸泡30min。C组在浸泡海水结束后于损伤部位贴敷新型渗透性敷料。于模型制备成功后72h时进行改良神经功能缺损评分(modified neurological severity score,mNSS)和旷场实验评估大鼠神经功能状态。行为学测定结束后处死大鼠,测定脑组织含水量及伊文思蓝(Evansblue,EB)含量。苏木精-伊红染色染色观察脑组织形态,Nissl染色检测神经元存活情况,透射电镜观察神经元超微结构改变,酶联免疫吸附试验(ELISA)检测炎症相关因子(NF-кB、TNF-α、IL-10)表达情况。结果新型渗透性敷料能够包裹生理盐水并且以一定速率渗透出生理盐水,45min后渗出约80%左右。病理学检查可见,B组出现明显脑水肿,脑出血严重;C组脑出血及脑水肿较B组减轻。Nissl染色显示,A组神经元结构完整,C组髓鞘完整性与神经元存活数量均明显优于B组。透射电镜下,B组线粒体缩小、线粒体膜增厚、嵴断裂,C组细胞核染色质部分发生边集,线粒体破坏减少。与B组比较,C组大鼠神经功能评分降低,脑组织中NF-кB、TNF-α含量显著降低(均P<0.05),IL-10含量显著升高(P<0.05)。结论新型渗透性敷料能有效促进TBI合并海水浸泡伤大鼠神经功能恢复,其机制可能与调节炎性反应有关。Objectives To investigate the neuroprotective effect of a new permeable dressing in rats of traumatic brain injury(TBI)combined with seawater immersion(SI).Methods A new permeable dressing was prepared by using methylacrylylated gelatin and conductive polypyrrole,and by wrapping normal saline in the hydrogel.36 SD rats were randomly divided into sham-operated group(Group A,n=12),TBI+SI group(group B,n=12)and penetrating dressing group(group C,n=12).The rat models were prepared by cranial percussion apparatus and immersed in artificial seawater for 30min.In the group C,a new penetrating dressing was implanted at the injured site after SI.The neural function of rats was evaluated by modified neurological severity score(mNSS)and open field test 72h post injury.After the behavioral test,the brain water content and Evans blue(EB)content were determined.The morphology of brain tissue was observed by hematoxylin-eosin(HE)staining.The survival of neurons was detected by Nissl staining.The ultrastructural changes of neurons were observed by transmission electron microscope.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of inflammation-related factors(NF-кB,TNF-α,IL-10).Results The new permeable dressing can wrap the saline and permeate the saline at a certain rate,and about 80%of the saline exudates after 45 minutes.Pathological examination showed obvious cerebral edema and severe cerebral hemorrhage in group B.Cerebral hemorrhage and cerebral edema in group C were less than group B.The myelin integrity and survival number of neurons in group C were significantly better than those in group B.Under transmission electron microscopy,mitochondria in group B were reduced,mitochondrial membrane thickened and ridge broken,and chromatin in group C had edge aggregation and mitochondrial damage decreased.Compared with group B,the neural function scores of rats in group C were decreased,and the contents of NF-кB and TNF-αin brain tissue were significantly decreased(P<0.05),IL-10 content was significant

关 键 词：脑损伤 创伤性 海水浸泡伤 新型渗透性敷料 大鼠 

分 类 号：R651.15[医药卫生—外科学] R-332[医药卫生—临床医学]