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一种通过向硬脑膜下间隙灌注生理盐水诱导选择性脑低温的新方法:对猫短暂性脑缺血的影响。

A new method of inducing selective brain hypothermia with saline perfusion into the subdural space: effects on transient cerebral ischemia in cats.

作者信息

Noguchi Yasuhiro, Nishio Shinsaku, Kawauchi Masamitsu, Asari Shoji, Ohmoto Takashi

机构信息

Department of Neurological Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama 700 8558, Japan.

出版信息

Acta Med Okayama. 2002 Dec;56(6):279-86. doi: 10.18926/AMO/31690.

Abstract

In this study, we tested brain surface cooling as a new method of inducing selective brain hypothermia, and evaluated its effects on focal cerebral ischemia using a cat model of transient middle cerebral artery (MCA) occlusion. Cats underwent 1 h of MCA occlusion followed by 5 h of reperfusion. Brain surface cooling was induced for 4 h during and after MCA occlusion in the hypothermia group, but not in the normothermia group. Brain surface cooling was performed using saline perfusion into the subdural space. Rectal temperature, brain surface temperature, and deep brain temperature were monitored, and regional cerebral blood flow (rCBF) and somatosensory evoked potential (SEP) were serially measured. After 5 h of reperfusion, water content was also measured. Although the rectal temperature was maintained at about 37 degrees C, the brain surface temperature decreased rapidly to 33 degrees C and was maintained at that temperature. For 3 h following reperfusion, the rCBF was lower in the hypothermia group than in the normothermia group. At 4 and 5 h after reperfusion, the recovery of SEP amplitude was significantly more enhanced in the hypothermia group than in the normothermia group. In the gray matter, the water content was significantly more diminished in the hypothermia group than in the normothermia group. These results demonstrate that our method is useful for protecting the ischemic brain from a transient MCA occlusion. This method may be adapted for neurological surgery.

摘要

在本研究中,我们测试了脑表面冷却作为诱导选择性脑低温的一种新方法,并使用短暂性大脑中动脉(MCA)闭塞的猫模型评估了其对局灶性脑缺血的影响。猫经历1小时的MCA闭塞,随后再灌注5小时。在低温组中,在MCA闭塞期间及之后诱导脑表面冷却4小时,而在正常体温组中则不进行。通过向硬脑膜下间隙灌注生理盐水来进行脑表面冷却。监测直肠温度、脑表面温度和脑深部温度,并连续测量局部脑血流量(rCBF)和体感诱发电位(SEP)。再灌注5小时后,还测量了含水量。尽管直肠温度维持在约37摄氏度,但脑表面温度迅速降至33摄氏度并维持在该温度。再灌注后3小时内,低温组的rCBF低于正常体温组。再灌注后4小时和5小时,低温组SEP波幅的恢复明显比正常体温组增强。在灰质中,低温组的含水量明显比正常体温组减少。这些结果表明,我们的方法对于保护缺血性脑免受短暂性MCA闭塞是有用的。该方法可能适用于神经外科手术。

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