不同方式亚低温对兔心肺复苏后脑保护作用的比较(英文)

Protective effects of different sub-hypothermia methods on brain in rabbits after cardiopulmonary resuscitation

背景:亚低温具有脑保护作用。目前采用的亚低温方法很多,不同方法形成亚低温的速度不同,更快形成亚低温是否具有更好的脑保护作用。目的:评估和比较体外血液冷却和体表降温形成亚低温对兔心肺复苏后的脑保护作用。设计:随机对照的实验研究。地点和材料:实验地点:武汉大学人民医院神经内科实验室进行实验。选取家兔20只,雌雄各半,随机分为体表亚低温组(10只)和体外血液冷却降温组(10只)。干预:电击室颤致搏心停5min再复苏,体表亚低温组采用体表冰敷形成亚低温,体外血液冷却降温组采用体外血液冷却法形成亚低温,24h后评定总体情况分类(overallperformancecategory,OPC)和神经功能缺损评分(neurologicaldeficitscore,NDS)。第72小时处死,取脑病检,评定组织病理学损害评分(histopathologicdamagescore,HDS)。主要观察指标:①两组冷却所需时间。②OPC和NDS,HDS。结果:体外血液冷却降温组(8.3±3.2)min形成亚低温的时间明显快于体表亚低温组(86.3±13.9)min,体外血液冷却降温组HDS(42±28)优于体表亚低温组(63±31),OPC,NDS两组间差异无统计学意义。结论:越早形成亚低温脑保护作用越好,体外血液冷却法比体表降温能更早形成亚低温,具有更好的脑保护作用。

BACKGROUND:Sub-hypthermia can protect brain.At present,there are a lot of sub-hypeothermia methods which are formed by different speed.If the quicker formed sub-hypothermia has the better protective effects on brain.OBJECTIVE:To evaluate and compare the protective effects of sub-hypothermia on brain by extravascular cooling and surface cooling to rabbits after cardiopulmonary resuscitation.DESIGN:A randomized case control study.SETTINGS and MATERIALS:Experiment site:Neurological Lab of Renmin Hospital of Wuhan University.Twenty rabbits with half male and half female were randomly divided into surface sub-hypothermia group(10 rabbits) and extravascular sub-hypothermia group(10 rabbits).INTERVENTIONS:Rabbits were resuscitated after 5 minutes of cardiac arrest induced by ventricular fibrillation.Ice compress on body surface was used to make sub-hypothermia in surface cooling group while extravascular cooling was used in extravascular sub-hypothermia group.Overall performance category(OPC) and neurological deficit score were assessed after 24 hours.Rabbits were executed in the 72 hours.Brain was removed to perform histopathologic damage score(HDS) assessment.MAIN OUTCOME MEASURES:①cooling time of each group.②OPC, NDS and HDS.RESULTS:The cooling time of extravascular cooling group[(8.3±3.2) minutes] was much shorter than that of surface cooling group[(86.3±13.9) minutes].The HDS of extravascular cooling group(42±28) was better than that of surface cooling group(63±31).There was no difference on OPC,NDS between two groups.CONCLUSION:The earlier the sub-hypothermia forms,the better the protective effects on brain.Sub-hypothermia can be formed much quicker by extravascular cooling method which has better protective effects ON brain than surface cooling method.