改良颅内加压法兔脑死亡模型建立及其状态的维持

Establishment of brain death model for rabbits in a modified way by increasing intracranial pressure and maintaining the state of brain death

目的探寻改良颅内加压法制作兔脑死亡模型及维持脑死亡状态的方法。方法新西兰大白兔15只,随机分成2组:假手术组(B组,n=6),仅颅内插管,行麻醉维持;脑死亡组(A组,n=9),通过改良的颅内加压法制作脑死亡模型。记录平均动脉压(MAP)和心率(HR)的变化。通过呼吸机和血管活性药物将生命体征维持在某一可控水平。结果 A组9只兔中8只建模成功,在颅内加压过程中随着颅内压力的增高,MAP和HR呈波浪状逐渐升高。麻醉状态下和脑死亡时MAP峰值分别为(80.63±8.45)mm Hg、(111.63±7.71)mm Hg,二者相比有统计学意义(P<0.05)。麻醉状态下、脑死亡时和脑死亡后2 h的HR分别为(153.25±14.35)次/min、(262.38±16.60)次/min和(218.50±10.27)次/min,三者之间两两相比具有统计学差异(P<0.05)。结论与传统术式相比,改良后的方法可以稳定、可靠地建立兔脑死亡模型;通过及时有效的呼吸、循环支持,脑死亡状态可以长时间维持。

Objective To explore the modified increasing intracranial pressure method to set up the brain death model for rabbits and sustain the state of brain death. Methods 15 healthy New Zealand rabbits were divided into brain death group（ Group A,n = 9） and sham operation group（ Group B,n = 6） randomly. The 9 brain death rabbits were set up by increasing intracranial pressure in a modified way. The sham operation rabbits were only sustained with anesthesia.Recorded the mean artery pressure（ MAP） and heart rate（ HR）. Results In group A,the 8 brain death rabbits were successfully set up. Only 1 died of heart failure. Compared to Group B,the MAP and HR of Group A rise up greatly during increasing intracranial pressure and presented an increasing trend. The peak MAP and HR were（ 111. 63 ± 7. 71） mm Hg and（ 262. 38 ± 16. 60） beats / min which were much higher than the MAP（ 80. 63 ± 8. 45） mm Hg and HR（ 153. 25 ±14. 35） beats / min before increasing intracranial pressure（ P 〈0. 05）. After brain death,MAP decreased sharply to45 mm Hg. 2 hours after brain death,HR（ 218. 50 ± 10. 27） beats / min presented an decreasing trend too,which showed asignificantly statistic difference to peak HR（ 262. 38 ± 16. 60） and HR（ 153. 25 ± 14. 35） beats / min before brain death（ P 〈0. 05）. Conclusions Compared to traditional method,the brain death model could be established stably and securely in the modified way and maintained for long time with the respiration and circulation supports.