脂肪乳注射液治疗碘油脑栓塞的实验研究

目的探讨脂肪乳注射液对颅内碘油清除的作用。方法：2只家兔按随机数字表法分成2组，对照组、实验组各6只，均通过颈内动脉穿刺注入超液态碘油（0．06ml／kg），CT扫描发现脑内有碘油沉积为造模成功。实验组造模成功后即刻经静脉注射脂肪乳（20ml／kg），并于其后每隔24h，即术后24、48、72、96、120h分别注射1次脂肪乳，共6次，并于上述时间点及术后144h各行1次头颅CT扫描。对照组不做治疗，并于相同时间点行CT扫描。选取碘油沉积最明显的0．1cm×0．1emROI测量CT值。2组间不同时点比较采用重复测量的方差分析，2组问相同时点比较采用两独立样本t检验，并观察动物的临床症状变化情况。结果术后24、48、72、96、120、144h，对照组ROICT值分别为（103．8±7．1）、（91．0±4．2）、（79．5±5．5）、（67．8±6．6）、（53．9±5．1）、（39．9±3．1）HU，实验组相应时间点ROIcT值分别为（90．7±5．4）、（74．1±4．6）、（62．9±4．5）、（48．1±3．1）、（39．1±1．3）、（38．8±1．2）HU。重复测量的方差分析显示，2组间不同时间点CT值差异有统计学意义（F=201．30，P〈0．01）。两独立样本￡检验比较显示，2组间术后24～120h相同时间点CT值的差异有统计学意义（t值分别为3．60、6．64、5．72、6．62、6．89，P值均〈0．01）。造模成功后，所有动物均出现不同程度卒中症状，实验组临床症状完全消失较对照组提前24h。结论脂肪乳注射液能加速颅内碘油清除，本实验为临床应用脂肪乳治疗碘油脑栓塞提供了一定的理论依据。

Objective To evaluate the value of removing intracranial lipiodol by fat emulsion injection.Methods Twelve rabbits were randomly divided into two groups,control group(n=6) and experimental group(n=6).All rabbits were injected lipiodolvia the internal carotid artery(0.06 ml/kg).When lipiodol was found intracranially by CT scan,the model was considered to be successful.The rabbits were then injected with fat emulsions intravenously immediatedly following the CT and at intervals of 24 hours,for a total of 6 times(20 ml/kg).Subsequently,the experimental group of rabbits underwent head CT scan at that time and 144 hours later.The control group without treatment underwent head CT scan at the same time interval.The highest density of 0.01 cm2 was selected as region of interest and the CT value was measured.Comparison between the two groups at different times used repeated measurements of ANOVA.Same time points between the two groups were compared using the two independent-samplesttest.Changes of clinical symptoms were observed in rabbits.Results At 24,48,72,96,120 hours,144 hours post-treatment,the CT values of the ROI in the control group and the experimentalgroupwere(103.8 ±7.1),(91.0±4.2),(79.5 ±5.5),(67.8±6.6),(53.9±5.1),(39.9±3.1)HU respectively and(90.7-±5.4),(74.1±4.6),(62.9±4.5),(48.1±3.1),(39.1±1.3),(38.8± 1.2)HU respectively.The results of the repeated measurementsof ANOVA showed that the CT values difference of the two groups at different time was statistically significant(F=201.30,P＜0.01).The results of the two independent-samples t test showed that the CT values difference of 24 to 120 hours posttreatment of the two groups also was statistically significant(t=3.60,6.64,5.72,6.62,6.89,P＜0.05).After the intra-arterial injection of lipiodol,all animals had different degrees of stroke symptoms.Clinical symptoms disappeared earlier in the experimental group than the control group by 24 hours.Conclusion Fat emulsions can accelerate the intracranial lipiodolclearence.This study provides some theoretical basis for clinical treatment of cerebrallipiodol embolism.