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目的 对植入式颈动脉压迫训练的效果进行研究。方法 将实验犬分为 3组 ,低血压状态下直接结扎组 6只 ,低血压状态下训练结扎组 6只 ,对照组 3只 ,前两组均降低血压 30～ 40mmHg ,将其颈总动脉暴露 ,训练组在电磁流量计监视下 ,利用颈动脉阻断夹每隔 8小时阻断其血流的 2 0 % ,直至全部阻断 ,结扎组经过相同的处理时间后 ,直接结扎其颈总动脉 ,每组动物在实验前及处死前做SPECT检查。SPECT值以中间层及其上下两层的右/左值取均值。结果 SPECT值 ,在α=0 .0 1时 ,训练组比结扎组有显著提高 ,两者皆与正常值有显著差异。组织学改变为结扎组 2只双侧、其余同侧出现了严重的脑缺血改变 ,训练组有 1只双侧、1只单侧出现了轻微的脑缺血改变。结论 植入式颈动脉压迫训练的方法可以明显提高单侧颈动脉阻断后脑对缺血的耐受能力 ,为临床上进行颈动脉外科手术提供了一个可行的思路。SPECT值可以准确地反应脑血流的状态及大脑两侧侧支循环建立情况
Objective To study the effect of implanted carotid artery compression training. Methods The experimental dogs were divided into 3 groups: 6 in the direct ligation group under hypotension, 6 in the training ligation group under hypotension, and 3 in the control group. The blood pressure in the former two groups was reduced by 30-40 mmHg and the common carotid artery was exposed. The training group under the surveillance of the electromagnetic flowmeter used a carotid blocking clip to block 20 % of its blood flow every 8 hours until it was completely blocked. After the same treatment time, the ligation group ligated the common carotid artery directly. Each group of animals was examined by SPECT before and before sacrifice. The SPECT value takes the mean of the right/left values of the middle layer and its upper and lower layers. Results The SPECT value was significantly higher in the training group than in the ligation group at α=0.01, both of which were significantly different from the normal values. The histological change was a bilateral cerebral ischemia in 2 rats in the ligation group. There was a single cerebral ischemia in one of the bilateral and 1 unilateral groups in the training group. Conclusion The method of implanted carotid artery compression can significantly improve the brain’s tolerance to ischemia after unilateral carotid artery occlusion, and provides a feasible way for clinical carotid artery surgery. SPECT can accurately reflect the state of cerebral blood flow and the establishment of collateral circulation on both sides of the brain