摘要
目的探讨不同灌洗液、不同麻醉对膀胱大量灌注后家兔脑水肿的影响,为预防临床大量膀胱灌注引起的脑水肿提供理论依据。方法健康雄性家兔20只,体重(3.5±0.3)kg,随机分为4组(n=5):A组(腰麻+5%葡萄糖注射液)、B组(腰麻+5%甘露醇注射液)、C组(丙泊酚全麻+5%葡萄糖注射液)、D组(丙泊酚全麻+5%甘露醇注射液)。所有家兔根据不同处理方式制作相应模型。所有家兔均在实验前后抽取静脉血查血糖和血清钠浓度;干-湿重法检测脑组织的含水量;免疫组化法检测AQP4表达。结果A组与C组灌注后血糖增加明显高于B组与D组(P<0.05);四组灌注后血清钠浓度都明显下降(P<0.05),四组之间血清钠变化无明显差异(P>0.05);A组脑组织含水量和脑组织AQP4含量明显高于其他组(P<0.05),在B、C、D三组之间,B组与C组无明显差异(P>0.05),D组含量低于B组和C组(P<0.05)。结论在大量膀胱灌注中,使用5%甘露醇注射液灌洗,丙泊酚麻醉可有效的预防渗透性脑水肿的发生。
Objective To investigate the effects of two different kinds of irrigation solution and anesthesia on rabbit brain edema caused by a geat deal of preoparative bladdar perfusion in an attempt to provide a theoretical basis for the prevention of brain edema. Methods Twenty healthy male rabbits weighing（3.5 ±0.3）kg were randomly divided into 4 groups（n=5）： Group A spinal anesthesia ＋5% glucose,Group B spinal anesthesia ＋5% mannitol,Group C propofol general anesthesia ＋5% glucose and Group D propofol general anesthesia ＋5% mannitol. The corresponding models were prepared in all the rabbits according to different treatment. The venous blood was collected from all the rabbits and blood glucose and serum sodium concentration were detected before and after the test. The brain tissue water content was detected by the dry-wet weight method and aquaporin-4（AQP4） expression by immunohistochemistry. Results The blood sugar level was significantly increased in Groups A and C than that in Groups B and D（P〈0.05） and the serum sodium level was significantly deceased after bladder irrigation in all the four groups（P〈0.05）, and there was no significant difference in the serum sodium level changes among the four groups（P〉0.05）. The brain tissue water content and AQP4 level were significantly higher in Group A was significantly higher than those of other three groups（P〈0.05）,and lower in Group D than those in Groups B and C, with no significant difference between Groups B and C. Conclusion The osmotic brain edema can be availably prevented by anaesthesia of propofol and a great deal of preoparative bladdar irrigation with 5% mannitol.
出处
《中国现代医生》
2009年第36期15-17,F0003,共4页
China Modern Doctor
关键词
灌洗液
麻醉
膀胱灌注
脑水肿
Irrigation solution
Anaesthesia
Bladdar irrigation
Brain edema
