基于生物电阻抗技术的无创脑水肿动态监护仪在猕猴脑出血及血肿扩大模型中的监测研究

Monitoring study of non-invasive cerebral edema dynamic monitor based on bioelectrical impedance technique in rhesus monkey intracerebral hemorrhage and hematoma enlargement model

目的应用猕猴脑出血(ICH)模型,观察基于生物电阻抗技术的无创脑水肿动态监护仪对病情变化的监测能力,明确该仪器在颅脑出血及后续血肿扩大过程中的数据变化规律,为其在临床脑出血患者病情监测中的应用奠定基础。方法健康成年雄性猕猴3只,通过股动脉抽取自体血5 mL,采用二次注入法制备猕猴脑出血及血肿扩大模型。应用有创颅内压监测仪和无创脑水肿动态监护仪同时对造模动物进行病情动态监测,术后通过MRI确认脑出血造模情况。结果猕猴在脑出血造模后,出现了相应的神经损伤症状,MRI可见脑内血肿位置、大小固定,表明该造模方法较为稳定。另外,有创颅内压监测指标与无创脑水肿监护仪扰动系数、相位斜率的变化趋势基本一致。结论本研究建立的猕猴脑出血模型,可以较稳定、可靠地模拟脑出血和血肿扩大的病情及其变化。无创脑水肿动态监护仪可以比较直观地反映脑内血肿变化情况,结合其操作方法简单、无创伤和可以持续动态监测的优点,为该设备用于临床脑出血患者的病情监测和临床治疗指导提供了重要的实验依据。

Objective The rhesus monkey intracerebral hemorrhage(ICH)model was used to observe the monitoring ability of non-invasive cerebral edema monitor based on bioelectrical impedance technique.To clarify the change rule of the instrument in the process of ICH and subsequent hematoma enlargement.To lay a foundation for its application in clinical monitoring of patients with ICH.Methods In 3 healthy adult male rhesus monkeys,5 mL of autologous blood was extracted from the femoral artery.The model of ICH and hematoma enlargement in rhesus monkey was established by secondary injection.Invasive intracranial pressure monitor and non-invasive cerebral edema monitor were used to continuously monitor the condition of the model,and the condition of model was confirmed by MRI after operation.Results The corresponding neurological symptoms appeared after the establishment of the model.MRI showed that the location and size of ICH were fixed,indicating that the modeling approach was relatively viable.In addition,the changing trends of disturbance coefficient and phase slope of invasive intracranial pressure monitoring instrument was broadly consistent with that of noninvasive brain edema monitor.Conclusions The study indicates that rhesus monkey model can reliably simulate the condition of cerebral hemorrhage and hematoma enlargement.The noninvasive dynamic monitor of cerebral edema can directly reflect the changes of ICH.Combined with the advantages of simple,noninvasive and continuous dynamic monitoring,it provides a basis for the clinical application.