论文部分内容阅读
背景:亚低温具有脑保护作用。目前采用的亚低温方法很多,不同方法形成亚低温的速度不同,更快形成亚低温是否具有更好的脑保护作用。目的:评估和比较体外血液冷却和体表降温形成亚低温对兔心肺复苏后的脑保护作用。设计:随机对照的实验研究。地点和材料:实验地点:武汉大学人民医院神经内科实验室进行实验。选取家兔20只,雌雄各半,随机分为体表亚低温组(10只)和体外血液冷却降温组(10只)。干预:电击室颤致搏心停5min再复苏,体表亚低温组采用体表冰敷形成亚低温,体外血液冷却降温组采用体外血液冷却法形成亚低温,24h后评定总体情况分类(overallperformancecategory,OPC)和神经功能缺损评分(neurologicaldeficitscore,NDS)。第72小时处死,取脑病检,评定组织病理学损害评分(histopathologicdamagescore,HDS)。主要观察指标:①两组冷却所需时间。②OPC和NDS,HDS。结果:体外血液冷却降温组(8.3±3.2)min形成亚低温的时间明显快于体表亚低温组(86.3±13.9)min,体外血液冷却降温组HDS(42±28)优于体表亚低温组(63±31),OPC,NDS两组间差异无统计学意义。结论:越早形成亚低温脑保护作用越好,体外血液冷却法比体表降温能更早形成亚低温,具有更好的脑保护作用。
Background: Mild hypothermia has neuroprotective effects. At present, there are many methods of using mild hypothermia, different methods of forming mild hypothermia at different rates, and faster formation of mild hypothermia with better brain protection. OBJECTIVE: To evaluate and compare the protective effects of hypothermia on the rabbits after cardiopulmonary resuscitation (CPB) in vitro. Design: Randomized controlled experimental study. Location and Materials: Experimental Location: People’s Hospital of Wuhan University Neurology Laboratory experiments. Twenty rabbits were selected and divided into two groups: male and female, randomly divided into body hypothermia group (n = 10) and blood cooling group (n = 10). Intervention: electric shock ventricular fibrillation induced cardiac arrest 5min and then resuscitation, body surface hypothermia using surface ice formation of mild hypothermia, extracorporeal blood cooling cooling group formed by extracorporeal blood cooling hypothermia, assessment of the overall classification 24h after (overallperformancecategory, OPC) and neurologicaldeficitscore (NDS). The animals were sacrificed on the 72nd hour. The encephalopathy was taken and the histopathologic damage index (HDS) was assessed. MAIN OUTCOME MEASURES: ① Two groups of cooling time required. ② OPC and NDS, HDS. Results: The sub-hypothermia time of the blood cooling and cooling group (8.3 ± 3.2) min was significantly faster than that of the hypothermia group (86.3 ± 13.9) min and the HDS (42 ± 28) Group (63 ± 31), OPC, NDS no significant difference between the two groups. Conclusion: The earlier the hypothermia brain protection is, the better the in vitro blood cooling method can form hypothermia earlier than the body temperature, which has a better brain protection effect.