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目的 比较亚低温治疗急性脑梗死时 3种不同复温方式的效果。方法 30只大鼠随机分为自然复温组 (对照组 )、主动体外复温组 (光照法 )和主动体内复温组 (灌胃法 )。采用改良线栓法制备大鼠大脑中动脉供血区缺血 (MCAO)模型 ,6h后诱导亚低温 ,2 4h后开始复温 ,监测颅内压、血压、心率、肛温 ,复温过程结束后比较脑梗死体积、神经功能评分以及死亡率。结果 复温 4h后灌胃组肛温明显低于光照组 ,血压开始显著上升 (P <0 .0 5 ) ,6h后血压明显高于光照组 (P <0 .0 5 ) ;3组在复温过程中颅内压都明显高于复温前(P <0 .0 1) ,光照组复温后 4h颅内压低于对照组 (P <0 .0 5 ) ,灌胃组 6h后颅内压高于对照组 (P <0 .0 5 ) ;3组在复温过程中心率变化没有差异 (P >0 .0 5 ) ;复温结束后灌胃组血压、颅内压、神经功能评分、梗塞灶体积明显高于光照组 (P <0 .0 5 ) ,死亡率高于对照组和光照组 (P <0 .0 5 )。结论 在亚低温治疗急性脑梗死的复温方法中 ,灌胃法主动复温不可取 ,光照法主动体外复温效果较好。
Objective To compare the effects of three different rewarming methods in the treatment of acute cerebral infarction with mild hypothermia. Methods Thirty rats were randomly divided into natural rewarming group (control group), active rewarming group (light method) and active rewarming group (gavage method). The model of middle cerebral artery occlusion (MCAO) was established by modified thread method. After 6 hours, mild hypothermia was induced. After 24 hours, reperfusion was started. The intracranial pressure, blood pressure, heart rate and rectal temperature were monitored. After rewarming Comparisons of cerebral infarction volume, neurological function scores, and mortality. Results After rewarming for 4h, the rectal temperature in the gavage group was significantly lower than that in the light group, and the blood pressure began to increase significantly (P <0.05). After 6h, the blood pressure was significantly higher than that in the light group (P <0.05) The intracranial pressure was significantly higher than that before rewarming (P <0.01), and the intracranial pressure 4 hours after rewarming in the light group was lower than that in the control group (P <0.05) (P <0.05). There was no difference in heart rate between the three groups during rewarming (P> 0.05). After rewarming, blood pressure, intracranial pressure, neurological function score , Infarct size was significantly higher than the light group (P <0.05), the mortality rate was higher than the control group and the light group (P <0.05). Conclusion In hypothermia treatment of acute cerebral infarction in rewarming method, gavage active rewarming is not desirable, the light method of active in vitro rewarming better.