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开颅减压治疗猫急性脑梗塞的实验研究 |
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张嘉林 黄胜平
摘 要 目的：探索开颅减压术对大面积脑梗塞的治疗效果及实施手术的时机。方法：家猫50只，均行经左侧眼眶阻断左大脑中动脉造成局灶性脑梗塞。40只动物再行左侧开颅减压术，另外10只动物不行手术，手术组动物又分为4组，分别于血管阻断后6h、12h、24h及36h行脑梗塞侧开颅减压术。48h后观察脑梗塞范围的大小。结果：手术组梗塞范围小于对照组(P＜0.01)。手术组动物无死亡，而对照组死亡率为20％(P＜0.01)。手术组动物神经功能障碍亦低于对照组。血管阻断后早期手术(6h或12h)的脑梗塞范围比晚期手术组范围小（P＜0.01)。结论：开颅减压治疗大面积脑梗塞，可使梗塞范围减小，并降低死亡率和致残率，而早期手术效果更佳。
主题词 脑梗塞；减压；局部缺血；猫
Experimental study of decompressive craniectomy in
treating cat acute cerebral infarction model
ZHANG Jia-Lin, HUANG Sheng-Ping
Department of Neurosurgery, Nanfang Hospital, Guangzhou (510515)
Abstract AIM:To evaluate the effects of decompressive craniectomy for treating massive cerebral infarction and to determin the appropriate timing of the operation. METHODS: Focal cerebral ischemia was induced in 50 cats by middle cerebral cerebral artery occlusion through transorbital approach. Decompressive craniectomy was performed in 40 animals (in groups of 10 cats each)6, 12, 24, or 36 hours after vessel occlusion. Ten animals(control group) were not treated by decompressive craniectomy. The author used the infarcct volume at 48 hours as study endpoints. RESULTS: Animals treated by decompressive craniectomy resulted in significantly smaller infarct volumes than those without craniectomy (P＜0.01). None of the animals in the treated group died, but the mortality rate in the untreated group was 20% (P＜0.01). Neurological behavior was better in all animals of the treated group. The infarction size were significantly smaller in cats treated very early by the operation (6 hours or 12 hours) after the middle cerebral artery occlusion (P＜0.01). CONCLUSION: Decompressive craniectomy in treating cerebral ischemia reduces the mortality and improve outcome, especialy when the operation performed early.
MeSH Cerebral infarction; Decompression; Ischemia; Cats
急性缺血型脑梗塞是常见脑血管病之一，大脑中动脉(middle cerebral artery, MCA)供血区的大面积缺血常导致严重脑水肿，颅内高压甚至形成脑疝而死亡。临床治[1] [2] 下一页
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