重型颅脑外伤局灶低温与全身低温疗效的对比研究

The study of the effect of focal hypothermia therapy and intensive whole-body cooling therapy for rat after severe traumatic brain injury

目的 通过比较局灶低温治疗与全身低温治疗两种治疗方法在重型颅脑外伤治疗中的效果 ,探讨何者疗效更佳。方法 采用Feeney自由落体改良模型 ,设定假颅脑外伤模型组、颅脑外伤模型组、全身低温组及局灶低温组 (使用 2 5℃水降温 )。取伤灶处及其相邻区脑组织分别检测其水、Na+ 、K+ 含量。同时观察其病理改变。结果 局灶低温组神经元损伤数显著少于颅脑外伤模型组、全身低温组 (P <0 .0 1) ;局灶低温组水、Na+ 含量明显低于颅脑外伤模型组及全身低温组 (P<0 .0 5 ) ,K+ 含量明显高于颅脑外伤模型组及全身低温组(P <0 .0 1)。结论 与全身低温疗法相比较局灶低温疗法 (使用 2 5℃水降温 )在减轻脑水肿。

Objective To establish optimal hypothermia therapy according to the effect of focal hypothermia therapy and intensive whole-body cooling therapy for rat following severe traumatic brain injury (STBI). Methods Modified Feeney free-falling model was used in the study. Twenty-eight male Sprague-Dawley (SD) rats were randomly divided into four groups (n=28): STBI group, intensive whole-body cooling group, focal hypothermia group used by circulating 25℃ water and sham group. The contents of total sodium, potassium and water of the sustained brain close to traumatic brain tissue were detected and pathological changes were observed in four groups. Results The damaged neurons were significantly fewer in focal hypothermia group used by circulating 25℃ water than those in STBI group and intensive whole-body cooling group after STBI (P<(0.01)). The contents of water and total sodium were significantly lower in focal hypothermia group used by circulating 25℃ water than those in STBI group and intensive whole-body cooling group after STBI (P<(0.05)). The total potassium was significantly higher in focal hypothermia group used by circulating 25℃ water than that in STBI group and intensive whole-body cooling group after STBI (P<(0.01)). Conclusions The effect of focal hypothermia therapy used by circulating 25℃ water is significantly better than that of intensive whole-body cooling therapy in alleviating brain edema and reducing the number of the damaged neurons for rat following STBI.