高渗盐水和甘露醇对开颅手术家兔脑皮质微循环的影响

Effects of Hypertonic Saline and Mannitol on Cortical Cerebral Microcirculation in Rabbit Craniotomy Model

目的:比较高渗盐水和甘露醇对开颅手术家兔脑皮质微循环的影响。方法:选取30只家兔麻醉后机械通气,行开颅手术。采用随机数字表法分为高渗盐水组(HTS组)和甘露醇组(MTL组),每组15只。HTS组术中静脉输注3.2%的高渗盐水渗透治疗,MTL组术中静脉输注20%的甘露醇渗透治疗,应用旁流暗视野成像技术(SDF)评估脑皮质微循环,记录相应时间点的血流动力学数据;记录SDF成像同时,获取血液样本进行实验室分析。结果:渗透治疗前,两组家兔脑皮质微循环参数比较,差异无统计学意义(P>0.05);渗透治疗后,MTL组的微循环参数PPV、PSVD、PVD和MFI均低于HTS组(P<0.05)。结论:在家兔开颅手术中,HTS较MTL能更好地确保皮质脑微循环灌注。

Objective： To compare the effects of hypertonic saline and Mannitol on cerebral cortical mierocireulation in rabbit craniotomy model.Method： A total of 30 rabbits （ weight 2.0-3.0 kg ） were anesthetized and ventilated mechanically, then subjected to a eraniotomy, divided into HTS group and MTL group according to the random nurhber table method, 15 rabbits in each group.HTS group was intravenous infused 3.2% hypertonic saline, MTL group was intravenous infused 20% Mannitol.Evaluated cortical cerebral microcirculation by sidestream dark-field （ SDF ） imaging, recorded the hemodynamics data at homologous time, and analysed blood samples in laboratory at the same time.Result： Before the osmotherapy, the cortical cerebral microcireulation of two groups were no significant difference （ P〉0.05 ） .After osmotherapy, the proportion of perfused vessels, perfused small vessel density, perfused vessel density, and microvascular flow index of MTL group were lower than those of HTS group （ P〈0.05 ） .Conclusion： Compared with MTL group, HTS can guard cortical cerebral microcirculation better in rabbit craniotomy model.