Doi Kazuhisa, Kawano Takeshi, Morioka Yujiro, Fujita Yasutaka, Nishimura Masuhiro
Division of Pharmacology, Drug Safety and Metabolism, Otsuka Pharmaceutical Factory, Inc, Tokushima 772-8601, Japan.
Surg Neurol. 2006 Dec;66(6):565-71; discussion 571-2. doi: 10.1016/j.surneu.2006.06.058.
This study was conducted to investigate how various irrigation fluids used during neurosurgical procedures affect the degree of postoperative brain edema and cellular damage during experimental neurosurgery in rats.
The cerebral cortex was exposed and incised crosswise with a surgical knife under irrigation with an artificial CSF, lactated Ringer's solution, or normal saline. Four hours after injury, irrigation was stopped and brain tissue samples were obtained from injured and uninjured sites. Specific gravity, cerebrovascular permeability, and TTC staining of the samples were evaluated. Incision and irrigation of the brain were not performed on the control group.
At the injured site, specific gravities of the samples in the normal saline group and the lactated Ringer's solution group were significantly lower than the specific gravity in the artificial CSF group. The EB concentration was significantly higher in the lactated Ringer's solution group and relatively high in the normal saline group as compared with the artificial CSF group. TTC staining did not differ significantly between the artificial CSF group and the control group. It was significantly lower in the lactated Ringer's solution group and the normal saline group than in the control group and the artificial CSF group.
As compared with normal saline and lactated Ringer's solution, artificial CSF reduced postoperative brain edema, cerebrovascular permeability, and cellular damage in sites injured by experimental neurosurgery in rats.
本研究旨在探讨神经外科手术中使用的各种冲洗液如何影响大鼠实验性神经外科手术术后脑水肿程度和细胞损伤。
在人工脑脊液、乳酸林格氏液或生理盐水冲洗下,用手术刀横向切开并暴露大脑皮层。损伤后4小时,停止冲洗,从损伤部位和未损伤部位获取脑组织样本。评估样本的比重、脑血管通透性和TTC染色。对照组不进行脑切开和冲洗。
在损伤部位,生理盐水组和乳酸林格氏液组样本的比重显著低于人工脑脊液组。与人工脑脊液组相比,乳酸林格氏液组的伊文思蓝浓度显著更高,生理盐水组相对较高。人工脑脊液组和对照组之间的TTC染色无显著差异。乳酸林格氏液组和生理盐水组显著低于对照组和人工脑脊液组。
与生理盐水和乳酸林格氏液相比,人工脑脊液可减轻大鼠实验性神经外科手术损伤部位的术后脑水肿、脑血管通透性和细胞损伤。