不同方式颈静脉结扎对颅内压影响的实验研究

Experimental study on effects of intracranial pressure after different jugular vein ligations

目的 探索采用不同方式结扎颈静脉对颅内压的影响。方法 采用日本大耳兔作为实验对象 ,设立对照组、双侧颈外静脉结扎组、双侧颈内静脉结扎组、右侧颈静脉结扎组、同期双侧颈静脉结扎组、分期颈静脉结扎组 ,经颅顶钻孔于术后即刻、0 .5、1、2、3、4h测量颅内压。结果 对照组术后 4h内颅内压无明显变化 ;双侧颈外静脉结扎组术后颅内压轻度升高 ,4h后基本恢复至术后水平 ;双侧颈内静脉结扎组和右侧颈静脉结扎组术后颅内压有一定程度升高 ,但术后 4h明显下降 ;同期双侧颈静脉结扎组和分期颈静脉结扎组术后颅内压升高快 ,达到峰值后下降缓慢 ,术后 4h仍维持在较高水平 ,尤以同期双侧颈静脉结扎组显著。结论 结扎双侧颈外静脉对颅内压无明显影响 ,术后无须降颅内压处理 ;结扎双侧颈内静脉和结扎右侧颈静脉会出现一过性颅内压升高 ,术中、术后应密切观察病情变化 ;同期结扎双侧颈静脉和分期结扎颈静脉后颅内压上升速度快 ,下降缓慢 ,术中。

Objective To investigate the changes of intracranial pressure(ICP)after different jugular vein ligations(JVL). Methods 30 rabbits were divided into 6 groups randomly for bilateral external jugular vein ligation(BEJVL), bilateral internal jugular vein ligation(BIJVL), right jugular vein ligation(RJVL), simultaneous bilateral jugular vein ligation(SBJVL), staging jugular vein ligation(SJVL)and blank control(BC). Skull puncture technique was employed to get the values of ICP at 0, 0.5, 1, 2, 3, 4 h postoperatively. Results ICP didn't increase at 4h in control groups. After BEJVL, ICP increased slightly and fell to 0 h status within 4 h. After BIJVL and RJVL, ICP increased to some degree and decreased apparently at 4 h. After SBJVL and SJVL, ICP increased immediately and was high keeping after 4 h. Conclusion ICP didn't increase after BEJVL.The patients who suffered from BEJVL may need no prevention of intracranical hypertension. After BIJVL and RJVL, ICP may increase. The patients who suffered from BIJVL and RJVL should be closely watched for degree of illness. ICP increased immediately, but decreased gradually after SBJVL and SJVL. The patients who suffered from SBJVL and SJVL must be treated to prevent postoperative complications, such as intracranial hypertension and thrombosis.