Vatansev C, Ustün M E, Oğün C O, Taştekin G, Karabacakoğlu A, Yilmaz H
Department of General Surgery, Meram Faculty of Medicine, Selçuk University, Konya, Turkey.
Eur Surg Res. 2003 Jul-Aug;35(4):388-94. doi: 10.1159/000070612.
The aim of this study was to determine whether omental transposition at the time of focal cerebral ischemia can decrease ischemic brain damage produced in dogs, in a new ischemia model, which had been described by us.
In group 1 (n = 5), the left internal carotid artery and arterial circle of the brain (posterior communicating artery in humans) were occluded permanently. In group 2 (n = 5), additionally to this ischemia model, omental transposition was performed simultaneously. In the postoperative early period (first 24 h), single photon emission computed tomography (SPECT) and in the late period (72-96 h) SPECT and magnetic resonance imaging (MRI) of the brain were performed. Mann-Whitney U, paired t and Wilcoxon signed rank tests were used for statistical analyses, and p < 0.05 was considered significant.
The dogs had a neurological score (NS) of 3.6 +/- 0.5 and 3.4 +/-0.5 in groups 1 and 2, respectively, in the early period (p > 0.05). In the late period, the dogs had an NS of 4.4 +/- 0.5 and 5.6 +/- 0.5 in groups 1 and 2, respectively (p < 0.05). The NS of each group differed significantly between the early and late period (p < 0.05). Early SPECT imaging showed 50 +/- 7.0% and 52 +/- 8.4% hypoperfusion corresponding to the left middle cerebral artery territory in groups 1 and 2, respectively (p > 0.05). In the late period, the degree of hypoperfusion decreased to 34 +/- 5.5% and 12 +/- 4.8% in groups 1 and 2, respectively (p < 0.05). The degree of hypoperfusion in both groups changed significantly between the early and late period (p < 0.05). In T(1)- and T(2)-weighted MRI images, the volume of the lesion in group 1 was significantly greater than in group 2 (p < 0.001).
In our new ischemia model, simultaneous omental transposition is helpful in reversing the neurologic deficit and cerebral ischemic damage.
本研究旨在确定在我们所描述的一种新的缺血模型中，局灶性脑缺血时进行网膜转位是否能减少犬类产生的缺血性脑损伤。
在第1组（n = 5）中，永久性阻断左颈内动脉和脑动脉环（人类的后交通动脉）。在第2组（n = 5）中，除了这种缺血模型外，同时进行网膜转位。在术后早期（最初24小时），进行单光子发射计算机断层扫描（SPECT），在后期（72 - 96小时）进行脑部SPECT和磁共振成像（MRI）。采用曼 - 惠特尼U检验、配对t检验和威尔科克森符号秩检验进行统计分析，p < 0.05被认为具有显著性。
在早期，第1组和第2组犬的神经学评分（NS）分别为3.6 ± 0.5和3.4 ± 0.5（p > 0.05）。在后期，第1组和第2组犬的NS分别为4.4 ± 0.5和5.6 ± 0.5（p < 0.05）。每组的NS在早期和后期之间存在显著差异（p < 0.05）。早期SPECT成像显示，第1组和第2组分别有50 ± 7.0%和52 ± 8.4%的灌注不足对应于左大脑中动脉区域（p > 0.05）。在后期，第1组和第2组的灌注不足程度分别降至34 ± 5.5%和12 ± 4.8%（p < 0.05）。两组的灌注不足程度在早期和后期之间均有显著变化（p < 0.05）。在T1加权和T2加权MRI图像中，第1组的病变体积显著大于第2组（p < 0.001）。
在我们的新缺血模型中，同时进行网膜转位有助于逆转神经功能缺损和脑缺血损伤。
