经侧脑室对创伤性脑损伤进行亚低温治疗的疗效观察

An experimental study of mild hypothermia via lateral ventricle perfusion of cool Ringer's solution in rabbits after traumatic brain injury

目的采用经侧脑室灌注25℃林格氏液的方法对实验动物创伤性脑损伤进行亚低温治疗,观察其疗效并初步探讨相关治疗机制。方法共选取21只新西兰兔,将其随机分为对照组、颅脑外伤组及亚低温组。颅脑外伤组及亚低温组选用重物自由落体撞击方式制作脑损伤模型,对亚低温组实验动物脑损伤部位给予亚低温干预(经侧脑室灌流25℃林格氏液)。待治疗结束后提取各组实验动物损伤灶脑组织,分别检测其水、Na^+、K^+含量,同时观察神经细胞病理形态学改变情况。结果颅脑外伤组与亚低温组神经元损伤数量均明显多于对照组(P<0.01),但亚低温组神经元损伤数量显著少于颅脑外伤组(P<0.01);颅脑外伤组与亚低温组脑组织水分、Na^+含量均较对照组明显增多(P<0.01),但亚低温组水分、Na^+含量均显著低于颅脑外伤组(P<0.01);颅脑外伤组与亚低温组脑组织K^+含量均较对照组明显减少(P<0.01),但亚低温组K^+含量显著高于颅脑外伤组(P<0.01)。结论经侧脑室灌流25℃林格氏液进行亚低温干预对实验动物创伤性脑损伤具有显著疗效,能减轻脑水肿,抑制神经细胞损伤。

Objective To set up a new method of mild hypothermia via lateral ventricle in rabbits following traumatic brain injury （TBI）. Methods Twenty-one New Zealand rabbits were used for this study. TBI was produced with all the rabbits in anesthesia by using free-falling impact model. Animals were randomly divided into three groups： a TBI group, a mild hypothermia group （by perfusion of 25℃ Ringer＇s solution via the lateral ventricle） and a control group. The contents of water and total sodium, potassium of the brain region close to traumatic brain tissue were detected and pathological changes were observed in three groups. Results The number of the injured neurons was increased significantly in both TBI group and mild hypothermia group than that in control group at 72 h after TBI （P 〈0.01 ） , but the number of the damaged neurons in TBI group was more than that in mild hypothermia group （ P 〈0. 01 ）. The contents of water and total sodium were significantly higher in both TBI group and mild hypothermia group than those in control group at 72 h after TBI （ P 〈0. 01 ） , and were significantly lower in the mild hypothermia group than those in the TBI group （P 〈0.01 ）. The total potassium was significantly lower in both TBI group and mild hypothermia group than that in control group at 72h after TBI （ P 〈 0.01 ） , but the total potassium was significantly higher in mild hypothermia group than that in TBI group （ P 〈0.01 ）. Conclusion A new method of mild hypothermia therapy by perfusion of 25℃ Ringer＇s solution via the lateral ventricle in rabbits following TBI might be effective in alleviating brain edema and inhibiting neuron lesion following TBI.