Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protec...Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protect brain, deep hypotermic circulatory arrest ( DHCA.) combined with retrograde cerebral perfusion ( RCP) June 2003 Vol11 No2 through the superior vena cava ( n = 50) and simple DHCA ( n = 15) were used during the procedure. Blood samples for lactic acid level from the jugular vein were compared in both groups at different plase, and perfusion blood distribution and oxygen content difference between the perfused and returned blood were measured in some RCP patients. Results The DHCA time was 35.9 ± 8 min (10. 0 - 63. 0 min) and DHCA+ RCP time was 45.5 ± 17. 2 min (16. 0 - 81. 0 min)The resuscitationtime was 7.1 ± 1.6 h (4.4 - 9.4H)in DHCA patients and 5.4±2.2h(2.0-9.0 h)in RCP patients. Operation death was 3/15 in the DHCA group and 1/50 in the RCP patients. Central nervous complication展开更多
Purpose： To investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling. Methods： Twenty-four cases of traumatic diffuse brain swel...Purpose： To investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling. Methods： Twenty-four cases of traumatic diffuse brain swelling were analyzed retrospectively. Patients in nonsurgical group were treated by medicine therapy. Patients in surgical group were treated by external ventricular drainage plus medicine therapy. The first CT perfusion scan was completed within 4 -5 h after trauma and scanned again after 7 days. The changes of perfusion parameters in area-of- interest in two groups were analyzed and compared before and after treatment. Results： Compared with the nonsurgical group, the value of cerebral blood volume, cerebral blood flow and mean transit time in bilateral frontal temporoparietal grey matter, basal ganglia, cerebellum, and brain stem at pre- and post-therapy were increased significantly （p 〈 0.05） in surgical group, and consequently the prognosis of patients undergoing surgery was also better than that of nonsurgical group. Conclusion： External ventricular drainage can improve cerebral perfusion and increase survival quality for the patients with posttraumatic acute diffuse brain swelling.展开更多
Objective:To investigate the relationship between the temperature and the microvascular blood flow of the cerebral cortex, and the influence of electro-acupuncture (EA) on the cortical microcirculation. Methods: High ...Objective:To investigate the relationship between the temperature and the microvascular blood flow of the cerebral cortex, and the influence of electro-acupuncture (EA) on the cortical microcirculation. Methods: High temperature spots on the anterior ectosylvian and low temperature spots on the posterior suprasylvian on the cortical surface of 20 cats were identified using cortical infrared thermography (CIT); the blood flow in the microcirculation on these spots was measured with laser-Doppler flowmetry. EA was given at Zusanli (ST 36) and changes in the blood flow in the cerebral cortex microcirculation were detected. Results: 1) The mean temperatures on the high (34.83±0.24°C) and low (32.28±0.27°C) temperature spots were significantly different (P<0.001); this was indicative of a temperature difference on the cortical surface; 2) The average blood flow in the microcirculation of the high (266.8±19.2 PU) and low (140.8±9.9 PU) temperature spots was significantly different (P<0.001). 3) On the cortical high temperature spots, the mean blood flow in the microcirculation significantly increased from 266.8±86.8 PU before EA, to 422.5±47.4 PU following 5 minutes of EA (58.35%; P<0.01), and 431.8±52.8 PU 5 minutes after ceasing EA (61.84%; P<0.01). 4) On the low temperature spots, there were no significant differences in blood flow following 5 minutes of EA (146.3±11.5 PU), and 5 minutes after ceasing EA (140.5±11.6 PU), when compared with that before acupuncture (140.8±9.9 PU; P>0.9). Conclusion: The high temperature spots of the cortex are active functional regions of neurons with higher blood flow and a stronger response to EA. EA induces a significant increase in blood flow in the high temperature spots of the cortex.展开更多
文摘Objective To assess retrospectively the effects of different protective methods on brain in ascending aortic aneurysm surgery. Methods In 65 patients, aneurysm was dissected to the aortic arch or right arch. To protect brain, deep hypotermic circulatory arrest ( DHCA.) combined with retrograde cerebral perfusion ( RCP) June 2003 Vol11 No2 through the superior vena cava ( n = 50) and simple DHCA ( n = 15) were used during the procedure. Blood samples for lactic acid level from the jugular vein were compared in both groups at different plase, and perfusion blood distribution and oxygen content difference between the perfused and returned blood were measured in some RCP patients. Results The DHCA time was 35.9 ± 8 min (10. 0 - 63. 0 min) and DHCA+ RCP time was 45.5 ± 17. 2 min (16. 0 - 81. 0 min)The resuscitationtime was 7.1 ± 1.6 h (4.4 - 9.4H)in DHCA patients and 5.4±2.2h(2.0-9.0 h)in RCP patients. Operation death was 3/15 in the DHCA group and 1/50 in the RCP patients. Central nervous complication
文摘Purpose： To investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling. Methods： Twenty-four cases of traumatic diffuse brain swelling were analyzed retrospectively. Patients in nonsurgical group were treated by medicine therapy. Patients in surgical group were treated by external ventricular drainage plus medicine therapy. The first CT perfusion scan was completed within 4 -5 h after trauma and scanned again after 7 days. The changes of perfusion parameters in area-of- interest in two groups were analyzed and compared before and after treatment. Results： Compared with the nonsurgical group, the value of cerebral blood volume, cerebral blood flow and mean transit time in bilateral frontal temporoparietal grey matter, basal ganglia, cerebellum, and brain stem at pre- and post-therapy were increased significantly （p 〈 0.05） in surgical group, and consequently the prognosis of patients undergoing surgery was also better than that of nonsurgical group. Conclusion： External ventricular drainage can improve cerebral perfusion and increase survival quality for the patients with posttraumatic acute diffuse brain swelling.
基金supported by a grant from the National Natural Science Fund of China (No. 39770925)Science Research Fund of The Ministry of Personnel for Excellent Returnees (1998)Beijing Key Laboratory Fund of The Science and Technology Commission of Beijing (951890600)
文摘Objective:To investigate the relationship between the temperature and the microvascular blood flow of the cerebral cortex, and the influence of electro-acupuncture (EA) on the cortical microcirculation. Methods: High temperature spots on the anterior ectosylvian and low temperature spots on the posterior suprasylvian on the cortical surface of 20 cats were identified using cortical infrared thermography (CIT); the blood flow in the microcirculation on these spots was measured with laser-Doppler flowmetry. EA was given at Zusanli (ST 36) and changes in the blood flow in the cerebral cortex microcirculation were detected. Results: 1) The mean temperatures on the high (34.83±0.24°C) and low (32.28±0.27°C) temperature spots were significantly different (P<0.001); this was indicative of a temperature difference on the cortical surface; 2) The average blood flow in the microcirculation of the high (266.8±19.2 PU) and low (140.8±9.9 PU) temperature spots was significantly different (P<0.001). 3) On the cortical high temperature spots, the mean blood flow in the microcirculation significantly increased from 266.8±86.8 PU before EA, to 422.5±47.4 PU following 5 minutes of EA (58.35%; P<0.01), and 431.8±52.8 PU 5 minutes after ceasing EA (61.84%; P<0.01). 4) On the low temperature spots, there were no significant differences in blood flow following 5 minutes of EA (146.3±11.5 PU), and 5 minutes after ceasing EA (140.5±11.6 PU), when compared with that before acupuncture (140.8±9.9 PU; P>0.9). Conclusion: The high temperature spots of the cortex are active functional regions of neurons with higher blood flow and a stronger response to EA. EA induces a significant increase in blood flow in the high temperature spots of the cortex.
