两种不同甘露醇输注法对创伤脑水肿影响的比较

Comparison between Effects of Two Methods of Infusing Mannitol on Traumatic Brain Edema

目的 探讨经颈动脉输注甘露醇对颅脑损伤后的脑保护作用。方法 32只家兔随机平均分为正常组、盐水组(颅脑损伤后,经周围静脉输注生理盐水)、静脉组(颅脑损伤后,经周围静脉输注甘露醇)和动脉组(颅脑损伤后,经颈动脉输注甘露醇)等4组。输注试剂后2h,用低温电子自族共振(ESR)技术检测损伤区脑组织中的自由基(ROO·)幅值(Y_(max)),并测定损伤区脑组织的含水量。结果 正常组没有测到ROO·幅值信号。盐水组、静脉组ROO·幅值(Y_(max))分别为47.625±5.423和45.375±3.623,两者相较无明显差异(P>0.05),而动脉组ROO·幅值(41.000±1.927)则明显低于盐水组和静脉组(P<0.01)。盐水组脑组织含水量(73.33％±2.82％)明显高于正常组(P<0.01);静脉组(73.88％±1.65％)虽稍低于盐水组(P>0.05),但仍明显高于正常组(P<0.01);动脉组(70.97％±1.28％)则明显低于盐水组和静脉组,接近于正常组水平。结论 经颈动脉输注甘露醇对颅脑损伤后的脑组织有良好的保护作用。

Objective To evaluate protective effect of the infusing mannitol into the carotid artery on the brain in rabbits with craniocerebral injury. Methods The model of craniocerebral injury was made by feeny method in the rabbits. Thirty-two rabbits were divided into 4 groups, i.e. normal group, saline group (infusing 0.9% salt solution into the peripheral vein), vein group (infusing 20% mannitol into the peripheral vein) and artery group (infusing 20% mannitol into the carotid artery). The injured brain tissue were taken 2 hours after infusion of the experimental agents, and the amplitude value (Ymax) of the lipid superoxide free radical (ROO ) in the injured brain tissues, in which water contents were measured, were determined by the hypothermal electron spin resonace (ESR) technique. Results The signal of ROO amplitude was not detected in the normal brain tissues. There was the insignificant difference (P>0.05) in Ymax of ROO amplitude between both the saline and vein groups, but Ymax of ROO amplitude in the artery group was significantly lower than that in the saline and vein groups. There were significant differences in the water contenl of the brain tissues between both the normal and saline groups as well as both the vein and artery groups (P<0.01). Conclusion The infusing mannitol into the carotid artery has more significantly protective effects on the injured brain tissues than the infusing of il into the vein in the rabbits.