局灶亚低温联合人工脑脊液冲洗对脑外伤后脑水肿的影响

Effects of focal mild hypothermia and focal irrigation by artificial cerebrospinal fluid on brain edema after traumatic brain injury

目的检测局灶亚低温、人工脑脊液冲洗对脑外伤后脑水肿的影响。方法健康成年SD大鼠210只,随机分为假手术组(SO组)、脑外伤组(TBI组)、局灶亚低温组(FH组)、局部人工脑脊液冲洗组(FI组)、局灶亚低温联合人工脑脊液冲洗组(FIH组)。各组又按处死时间即伤后4 h、8 h、1 d、3 d、5 d、7 d分为6个亚组,用干湿重法检测脑组织水含量,原子吸收火焰分光光度法检测Na+、K+含量,光、电镜病理检查。结果脑外伤后各组脑组织水含量于伤后1 d达高峰,持续至第3天,第7天降至SO组水平。伤后8 h^5 d FIH组、FH组、FI组水含量均<TBI组(P<0.05);FIH组水含量<FH组和FI组(P<0.05)。各组钠含量变化趋势与水含量相近。结论局灶亚低温联合人工脑脊液冲洗能减轻脑外伤后脑水肿,其作用优于单一局灶亚低温或人工脑脊液冲洗。

[ Objective ] To observe the effects of focal mild hypothermia and focal irrigation by artificial cere- brospinal fluid （ACSF） on brain edema after traumatic brain injury. [Methods] A total of 210 healthy adult Sprague-Dawley rats were randomly separated to sham operation group （SO group）, traumatic brain injury animal model group （TBI group）, focal mild hypothermia group （FH group）, focal irrigation group （FI group） and focal hy- pothermia combined with focal irrigation group（FIH group）. Each group was divided into 6 subgroups by time of sac- rifice, namely 4 h, 8 h, 1 d, 3 d, 5 d and 7 d after trauma. The content of water was measured by the wet and dry weight method, the content of sodium （Na＋） and potassium （K~） was measured by a flame photometer, ultrastrueture was observed by light microscope and electron microscope. [ Results ] The water content of brain tissue in other four groups was significantly higher than that in the SO group at 4 h, 8 h, 1 d, 3 d and 5 d after trauma （P 〈 0.05）, and the peak value appeared on 1 ~3 d after trauma, and went back to normal level as in the SO group on 7 d after trau- ma （P 〉0.05）. The water content of the FIH group, the FH group and the FI group was markedly less than that of the TBI group from 8 h to 5 d after trauma （P 〈 0.05）. The water content of the FIH group was less than that of the FH group and the FI group （P 〈 0.05）. The change of sodium content in brain tissue had the same pattern as that of wa- ter content. [ Conclusions ] Focal hypothermia combined with focal irrigation by ACSF can alleviate the degree of brain edema after TBI. FIH has better effect on TBI than FH or FI alone.