携氧液对心脏停搏后脑复苏作用的观察

Effects of oxygencarrying solution on brain resuscitation after cardiac arrest

目的：研讨携氧液对脑复苏的作用。方法：用１２～１６ ｋｇ 杂种犬１６ 只，分实验组和对照组各８ 只，用低压直流电诱发心室颤动 １０ 分钟。实验组静滴携氧液５０ ｍ ｌ／ｋｇ；对照组静滴非携氧液（同量）。按相同程序心脑复苏。实验结果评估神经损伤指数（ Ｎ Ｄ）和整体表现评分，记录自主循环恢复时间和心排血量变化，对生化酶学指标进行检测，并观察各种神经反射的恢复情况和光镜、电镜观察中枢神经的形态变化。结果：复苏时实验组自主循环恢复时间〔（５１９±３６９）分钟〕比对照组〔（１２７６±８５２）分钟〕短，心排血量〔（９９９±３１５） Ｌ〕恢复较快并稳定，与对照组〔（６２６±１２４） Ｌ〕比较， Ｐ＜ ００５；７２ 小时实验组脑组织含水量（７４３０％ ±３３０％ ）与对照组（８０００％ ±４６０％ ）比较， Ｐ＜ ００５；实验组脑组织肌酸激酶同工酶〔（２９３７３±１３２） Ｕ／ Ｌ〕比对照组〔（７７３４４±１３０） Ｕ／ Ｌ〕更接近于正常。实验组７２ 小时存活率高（８７５％ 与５００％ ），神经生理反射快（角膜和瞳孔对光反射），中枢神经缺氧性形态改变较轻。结论：携氧液有助于提高脑复苏的成功率，减少缺氧性脑损伤?

Objective:To study the effect of oxygencarrying solution on brain resuscitation after cardiac arrest.Methods:16 mongrel dogs (1216 kg) were divided into two groups at random.Ventricular fibrillation was induced by low voltage direct current for 10 minutes.The animals of the test group were infused with oxygencarrying solution (50 ml/kg i.v.drop),and that of the control group received nonoxygencarrying solution.Cardiac and cerebral resuscitation were carried out by similar procedures.Neurologic deficit scores and overall performance categories were evaluated.Restoration of spontaneous circulation (ROSC) and cardiac output (CO) were analyzed.Pathological changes in cerebral tissue were examined under light microscope and electronmicroscope.Results:In animals treated with oxygencarrying solution,the ROSC time was shorter 〔(5 19±3 69)min vs.(12 76±8 52)min, P <0 05〕,CO maintained a higher level 〔(9 99±3 15)L vs.(6 26±1 24)L, P <0 05〕,and brain water contents (74 30%±3 30% vs.80 00%±4 60%, P <0 05) as well as creatine kinase BB isozyme values 〔(293 73±1 32)U/L vs.(773 44±1 30)U/L, P <0 01〕 were markedly lower compared with control group.Also,72 hour survival rate in test group was higher than that in the controls (87 5% vs. 50 0%).Inaddition,pathological changes in cerebral tissue were mild in test group.Conclusions:The present study suggests that oxygencarrying solution may be beneficial for improvement of brain resuscitation and attenuation of brain damage following cardiac arrest.