论文部分内容阅读
目的；探讨鼠6min窒息心脏骤停后，脑温度变化对脑水肿和脑血流的作用。方法：在浅麻醉和潘蔻罗宁麻痹下，心脏骤停前和后3h使用间歇正压通气。窒息6min后，给肾上腺素和碳酸氢钠并立即开始心肺复苏。激光－多谱勒血流计在皮质连续测定脑血流。在心脏骤停后3h，用碘125标记的白蛋白和湿重与干重的比例来测定脑水肿。自主循环恢复后15min，脑的温度，1组（n＝8）降低到30～31℃，2组（n＝8）保持在37～38℃，3组（n＝8）升高到39～40℃，保持3h，直肠的温度均保持在37～38℃，T检验比较组间资料的差异。结果：在自主循环恢复后1h和2h，1组完全防止了皮质低灌注，2组和3组的皮质脑血流明显低于心脏骤停前。血脑屏障渗透指数，1组（8．9±1．8）明显低于2组（17．1±2．4，P＜0．05）。结论：心脏骤停后，选择性脑低温能增加脑血流和预防脑水肿。
Objective To investigate the effect of cerebral temperature changes on brain edema and cerebral blood flow after 6-minute apoplexy in rats. METHODS: Intermittent positive pressure ventilation was used at 3 h before and after cardiac arrest under light anesthesia and pankronon paralysis. After 6 minutes of asphyxiation, epinephrine and sodium bicarbonate were given and cardiopulmonary resuscitation was started immediately. Laser - Doppler flowmetry in the cortical continuous determination of cerebral blood flow. At 3 h after cardiac arrest, brain edema was determined using iodine 125-labeled albumin and the ratio of wet weight to dry weight. After 15 minutes of spontaneous circulation recovery, the temperature of the brain in Group 1 (n = 8) decreased from 30 to 31 ° C, while in Group 2 (n = 8) maintained at 37 to 38 ° C, 40 ℃, holding 3h, rectal temperature were maintained at 37 ~ 38 ℃, T test to compare the differences between groups of data. Results: In the first and second hour after spontaneous circulation recovery, group 1 completely prevented the cortical hypoperfusion. The cortical cerebral blood flow in groups 2 and 3 was significantly lower than that before cardiac arrest. The blood-brain barrier permeability index in group 1 (8.9 ± 1.8) was significantly lower than that in group 2 (17.1 ± 2.4, P <0.05). CONCLUSIONS: Selective cerebral hypothermia increases cerebral blood flow and prevents cerebral edema following cardiac arrest.