摘要
目的探讨猴脑选择性超深低温断血流复苏前后的影像和病理变化。方法4～10岁健康恒河猴10只，随机分为三组：四血管（双侧颈总动脉及椎动脉）阻断冷灌注组，两血管（双侧颈总动脉）阻断等温灌注组，两血管阻断冷灌注组。常温下临时阻断双侧颈部血管后，通过一侧颈内动脉冷灌注，同侧颈内静脉回流，阻断其它颈部血管，建立选择性脑局部体外循环通路，降低脑温至（15．1±0．9）℃，60min恢复脑血流，实验动物自然复苏．于手术前，恢复脑血流后4h、24h、72h、21d分别行常规MRI（扫描序列包括T1WI、T2WI）弥散加权成像（diffuse weighted imagine，DWI）MRI，手术中持续监测生命体征及血流动力学指标变化，术后每周行神经功能缺失评分，脑组织及主要脏器行光镜观察。结果在10只实验猴中，两血管阻断冷灌注组4只恒河猴术中、术后血流动力学稳定，灌注60min后安全复苏并长期存活，术后头颅常规MRI和DWI检查未见异常，术后神经功能评分无异常，主要器官组织形态未见异常；两血管阻断等温灌注组2只及四血管阻断冷灌注组4只于灌注60min后均未能安全复苏，术后24h内死亡，四血管组1例术后存活超过6h，行DWI发现右基底节区有梗塞灶；余术后全部死亡，主要器官组织形态可见不同程度异常。结论猴脑在选择性超深低温状态下，阻断双侧颈总动脉血流60min后可安全复苏，阻断血流及复苏对血流动力学、脑组织形态及神经功能无明显影响。
Objective To study the change of image and pathology of monkey of resuscitation after selective cerebral ultra - deep hypothermia and blood flow occlusion. Methods From four to ten year - aged macaca mulattas were randomly divided into three groups, four- vessel occlusion group, two -vessel occlusion group and identical temperature perfusion group. Incising the sheathes of bilateral carotid arteries, ligating right common carotid artery, a catheter was distally inserted into right internal jugular artery （ICA） to connect cold prefusion system, two catheters were distally and proximally inserted into right internal jugular vein（IJV） and right femoral vein（FV） to connect the lead -in of the device of ultrafiltration and rewarming, a catheter was proximally inserted into left femoral vein to connect the ouffa of the device of ultrafiltration and rewarming, a catheter was proximally inserted into right IJV to monitor central venous pressure（CVP）. Clamping bilateral exteral jugular veins（ EJVs）, left ICA and IJV, four -vessel occlusion group was also clamped bivertebral artery （VA）. Cold solution （4.0 ± 0.5 ） ℃ was distally perfused into the right ICA to cool the brain, at the same time, two catheters were distally and proximally inserted into right IJV and right FV to reflu the blood of veins,the solution of refluing was perfused the systemic circulation by left FV after ultrafiltration and rewarming. The temperature of brain was maintained （ 14.3 - 16.0） ℃ for 60 minutes. MRI was examinated before and after operation , the vital signs and the hemodynamical parameters were monitored during the experiment, the dysfunctional scales of neurology were done every week, the brains and other vital organs were examined by microscopy. Results In all of ten monkeys, the hemodynamical parameters of two - vessel occulation were steady during the operation, and all of them lived up for ever after filled 60 minutes. MRI was normal after operation, the functions of neurological deficient scale w
出处
《医学信息（手术学分册）》
2007年第2期138-141,共4页
Medical Information Operations Sciences Fascicule
基金
云南省自然科学基金重点项目(No2003C0010Z)
教育部科学技术研究重点项目(No02141)
云南省自然科学基金资助项目(No2002C0052M)
上海市科委基础研究重点项目(No03JC14038)
关键词
猴
脑
低温
影像
病理
monkey
brain
hypothermia
Image
pathology
