急性弥漫性脑肿胀发病机制的实验研究.pdfVIP

中华创伤杂志980405 中华创伤杂志 科技期刊 CHINESE JOURNAL OF TRAUMATOLOGY 1998年 第14卷 第4期 Vol.14 No.4 1998 急性弥漫性脑肿胀发病机制的实验研究 吴思荣　惠国桢　印其章 　　【摘要】　目的　探讨急性弥漫性脑肿胀的发病机制。方法　电解毁损家兔下丘 脑背内侧核、中脑网状结构和延髓网状结构,观察脑血流量和颅内压的变化。结果　单 独毁损引起短暂可逆性脑血流量增加和颅内压增高,联合毁损引起持续不可逆性颅内压 增高,脑血流量超早期增加和早期减少,以及早期形成脑水肿。结论　大脑血管紧张性调 节中枢广泛存在于下丘脑、中脑和延髓,其结构或功能的破坏是急性弥漫性脑肿胀形成 的根本基础。 　　【关键词】　脑肿胀　下丘脑　中脑　延髓 Experimental Study on Pathogenesis of Acute Diffuse Brain Swelling　　WU Si-rong, HUI Guo-zhen, YIN Qi-zhang. Dept. of Neurosurgery, First Affiliated Hospital, Suzhou Medical College, Suzhou 215006 　　【Abstract】　Aim　To investigate the pathological mechanism of acute diffuse brain swelling. Methods　Cerebral blood flow (CBF) and intracranial pressure (ICP) were measured after electrolytical destruction of the dorsomedial nucleus of the hypothalamus, the midbrain reticular formation, or/and the reticular formation of the medulla oblongata. Results　Transient and reversible increases in CBF and ICP were found after respective destruction of these areas; while a progressive and irreversible increase in ICP, a superearly increase and an early reduction in CBF as well as early brain edema were found after simultaneous destruction of them. Conclusion　There exist vasomotor centers in the hypothalamus, the midbrain and the medulla oblongata, and the destruction of these centers is the basic reason for acute diffuse brain swelling. 　　【Key words】　Brain swelling　Hypothalamus　Midbrain　Medulla oblongata 　　外伤后急性弥漫性脑肿胀是颅脑损伤后的一种严重病症,它可单独存在或与各种类 型颅脑损伤同时并存,是影响脑外伤预后的重要因素之一 ［1］。本实验电解毁损家兔下 丘脑背???侧核 (DMH)、中脑网状结构(MBRF)和延髓网状结构(MORF),观察脑血流量(CBF)和颅内压 (ICP)变化,探讨急性弥漫性脑肿胀的发病机制。 材料与方法 　　1.动物准备:家兔35只,体重2.5～3kg,雌雄不拘。戊巴比妥钠30mg/kg静脉麻醉。气管 插管,人工呼吸。股动脉插管测量血压并间断抽血作血气分析,股静脉插管输液。 　　2.颅内压测定:采用SJN2081型颅内压监护仪和8081型光导纤维探头(均为无锡海鹰集 团生产),硬膜外法测定颅内压。 　　3.脑血流量测定:采用氢清除式组织血流测定仪(HCBF