期刊文献+

上胸段硬膜外阻滞与尼莫地平减轻兔脑血管痉挛作用的比较 被引量:2

Comparison of preventive effect of high thoracic epidural block on cerebral vasospasm with that of nimodipine in the rabbits
下载PDF
导出
摘要 目的比较上胸段硬膜外阻滞(HTEB)减轻兔蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的作用是否优于尼莫地平。方法切开置管法制备HTEB模型的新西兰兔60只,按随机数字表法随机分成4组(n=15):假手术组、对照组)、HTEB治疗组和尼莫地平治疗组。"枕大池二次注血法"(0.5ml/kg)制成兔SAH模型,1、7和14d后用经颅多普勒检测基底动脉平均血流速度(Vm)。处死后取基底动脉,光镜下观察其形态学变化。结果与假手术组相比,对照组、HTEB治疗组和尼莫地平组的基底动脉Vm均明显升高(P<0.01);但HTEB治疗组和尼莫地平组的基底动脉Vm明显低于对照组(P<0.05),而两治疗组差异无统计学意义(P>0.05)。光镜下,对照组基底动脉管壁增厚、管腔变窄;两治疗组管壁增厚不明显,管腔仍有狭小,较对照组明显改善;两治疗组之间血管壁变化无明显差异。结论 HTEB减轻兔SAH后CVS的程度与尼莫地平相当。 Objective To compare the preventive effects of high thoracic epidural block (HTEB) on cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) with that of nimodipine in rabbits. Methods HTEB at T6~7 epidural space was performed in 60 rabbits, who were randomly divided into 4 groups of 15 rabbits each, i. e. the sham-operation group, control group, HTEB treatment group, nimodipine treatment group. SAH was developed by two injection of autoblood into the cistern magna (0.5 ml/kg). Transcranial Doppler ultrasonography was used to detect the basilar artery mean flow velocity (Vm) 1, 7 and 14 days after SAH. The changes in histological morphology of the basilar artery were observed under a light Microscope. Results The Vm of the basilar artery in the control group and two treatment groups was significantly faster than that in the sham operation group (P〈0.01); The Vm of the basilar artery in the control group was significantly faster than that in both the treatment groups (P〈0.05); There were insignificant difference in the Vm of the basilar artery between both the treatment groups (P〉0.05). Pathological observations showed that in the control group the lumina of the basilar arteries was narrower and the basilar artery walls were thicker than those in the two treatment groups, but there were no significant difference in the walls thickness and the lumens sizs of the basilar arteries between the two treatment groups. Conclusion Continuous HTEB is similar to nimodipine in preventive effect on SAH-associated CVS in rabbits.
出处 《中国临床神经外科杂志》 2010年第12期736-739,共4页 Chinese Journal of Clinical Neurosurgery
关键词 上胸段硬膜外阻滞 尼莫地平 蛛网膜下腔出血 血管痉挛 颅内 High thoracic epidural block Nimodipine Subarachnoid hemorrhage Cerebral vasospasm
  • 相关文献

参考文献12

  • 1Bederson JB,Connolly ES,Batjer HH,et al.Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage:a statement for health care professionals from a special writing group of the Stroke Council,American Heart Association[J].Stroke,2009,40(3):994-1025.
  • 2杨涛,姜勇.细胞因子、粘附分子与蛛网膜下腔出血后脑血管痉挛的关系[J].中国临床神经外科杂志,2009,14(7):440-442. 被引量:4
  • 3Bunc G,Kovacic S,Strnad S.The influence of noradrenergic blockade on vasospasm and the quantity of cerebral dopamine beta-hydroxylase following subarachnoid hemorrhage in rabbits[J].Wien Klin Wechenschr,2003,115(17-18):652-659.
  • 4林剑清,陈国忠,刘韧,吴晓智,江鹤群,吴坛光.上胸段硬膜外阻滞对兔蛛网膜下腔出血后急性期脑血管痉挛的预防作用[J].中国临床神经外科杂志,2008,13(9):542-545. 被引量:4
  • 5陈志扬,薛张纲,蒋豪.全麻复合胸段硬膜外阻滞对兔实验性心肌梗死应激反应的影响[J].中华麻醉学杂志,2000,20(11):684-686. 被引量:33
  • 6Zhou ML,Shi JX,Zhu JQ,et al.Comparison between one-and two-hemorrhage models of cerebral vasospasm in rabbits[J].J Neurosci Methods,2007,159:318-324.
  • 7Bureak B,Onal MB,Narin F,et al.The effects of intravenous cilostazol and nimodipine on cerebral vasospasm after subarachnoid hemorrhage in an experimental rabbit model[J].Turk Neuresurg,2009,19(4):374-379.
  • 8Elias M.Cervical sympathetic and stellate ganglion blocks[J].Pain Physician,2000,3(3):294-304.
  • 9Gao C,Liu X,Shi H,et al.Relationship between sympathetic nervous activity and inflammatory response after subarachnoid hemorrhage in a perforating canine model[J].Auton Neurasci.2009,147(1-2):70-74.
  • 10Goellner E,Slavin KV.Cervical spinal cord stimulation may prevent cerebral vasospasm by modulating sympathetic activity of the superior cervical ganglion at lower cervical spinal level[J].Med Hypotheses,2009,73(3):410-413.

二级参考文献28

  • 1Polin RS,Bavbek M,Shaffrey ME,et al.Detection of soluble E-selectin,ICAM-1,VCAM-1,and L-selectin in the cerebral spinal fluid of patients after subarachnoid hemorrhage[J].J Neurosurg,1998,89:559-567.
  • 2Fasabender K,Hodapp B,Rossol S,et al.Inflammatory cytokines in subarachnoid hemorrhage:assoiciation with abnormal blood flow velocities in basal cerebral arteries[J].J Neurol Neurosurg Psychiatry,2001,70:534-537.
  • 3Schoch B,Regel JP,Wichert M,et al.Analysis of intrathecal interleukin-6 as a potential predictive factor for vasospasta in subarachnoid hemorrhage[J].Neurosurgery,2007,60:828-836.
  • 4Osuka K,Suzuki Y,Tanazawa T,et al.Interleukin-6 and development of vasosposm after subarachnoid hacmorrhage[J].Acta Neurochir (Wien),1998,140:943-951.
  • 5Kikuchi T,Okuda Y,Kaito N,et al.Cytokine production in cerebrospinal fluid after subarachnoid haemorrhage[J].Neurol Res,1995,17:106-108.
  • 6Gaetani P,Tartara F,Pignatti P,et al.Cisternal CSF levels of cytokines after subarachnoid haemorrhage[J].Neurol Res,1998,20:337-342.
  • 7Fasabender K,Hodapp B,Rossol S,et al.Endothelin-1 in subarachnoid hemorrhage:an acute-phase reactant preduced by cerebrospinal fluid leuqkocytes[J].Stroke,2000,31:2971-2975.
  • 8Kwon KY,Jeon BC.Cytokine levels in cerebrospinal fluid and delayed ischemic deficits in patients with aneurysmal subarachnoid hemorrhage[J].J Korean Med Sci,2001,16:774-780.
  • 9Bard CO,Mckee A,Parra A,et al.Possible role for vascular cell proliferation in cerebral vasospasm after sabarachnoid hemorrhage[J].Stroke,2003,34:427-433.
  • 10Vieweg U,Schramm J,Urbach H.Platelet-derived growth factor(PDGF-AB) like immune reactivity in serum and in cerebral spinal fluid following experimental subarachnoid haemorrhage in dogs[J].Acta Neurochir (Wien),1999,141:861-866.

共引文献36

同被引文献40

  • 1马景鑑,杨树源,魏伟,岳树源,钟跃,杨卫东,张大建,朱士广,朱涛,李萌,杨玉山,李牧,苏炳华,鄂正刚.盐酸法舒地尔治疗蛛网膜下腔出血所致脑血管痉挛的临床Ⅱ期试验研究[J].中华神经外科杂志,2006,22(1):36-40. 被引量:102
  • 2Hanggi D,Turowski B,Beseoglu K,et al.Intra-arterial nimodipine for severe cerebral Vasospasm after aneurysmal subaraehnoid hemorrhage:influenee on clinical course and cerebral perfusion[J].AJNR Am J Neuroradiol,2008,29(6):1053-1060.
  • 3Oran I,Cinar C.Continuous intra-arterial infusion of nimodipine during embolization of cerebral aneurysms associated with vasospasm[J].AJNR Am J Neuroradiol,2008,29(2):291-295.
  • 4Pearl JD,Maedonald RL.Vasospasm after aneurysmal subarachnoid hemorrhage:need for further study[J].Acta Neurochir Suppl,2008,105:207-210
  • 5Kronvall E,Undren P,Romner B,et al.Nimodipine in aneurysmal subarachnoid hemorrhage:a randomized study of intravenous or peroral ad ministration[J].J Neurosurg,2009,110(1):58-63.
  • 6Hanggi D,Eicker S,Beseoglu K,et al.A muhimodal concept in patients after severe aneurysmal subarachnoid hemorrhage:results of a controlled single centre prospective randomized muhimodal phaseⅠ/Ⅱtrial on cerebral vasospasm[J].Cent Eur Neurosurg,2009,70(2):61-70.
  • 7Linn J,Fesl G,Ottomeyer C,et al.Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome:a diagnostic tool in select cases?[J].Cephalalgia,2011,31(10):1074-1081.
  • 8Kim SS,Park DH,Lim DJ,et al.Angiographic features and clinical outcomes of intra-arterial nimodipine injection in patients with subarachnoid hemorrhage-induced vasospasm[J].J Korean Neurosurg Soc,2012,52(3):172-8.
  • 9Dorhout Mees SM,Rinkel GJ,Feigin VL,et al.Calcium antagonists for aneurysmal subarachnoid haemorrhage[J].Cochrane Database Syst Rev,2007,18(3):196-197.
  • 10Nishiguchi M,Ono S,Iseda K,et al.Effect of vasodilation by milrinone,a phosphodiesterase III inhibitor,on vasospastic arteries after a subarachnoid hemorrhage in vitro and in vivo:effectiveness of cisternal injection of milrinone[J].Neurosurgery,2010,66(1):158-164.

引证文献2

二级引证文献31

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部