【摘要】：目的:探討猴腦選擇性超深低溫?cái)嘌鲝?fù)蘇模型的制備方法,規(guī)范動(dòng)物模型。方法:4-10歲健康恒河猴10只,動(dòng)物隨機(jī)分為三組:四血管(雙側(cè)頸總動(dòng)脈及椎動(dòng)脈)阻斷冷灌注組,兩血管(雙側(cè)頸總動(dòng)脈)阻斷冷灌注組,兩血管(雙側(cè)頸總動(dòng)脈)阻斷等溫灌注組。切開雙側(cè)頸動(dòng)脈鞘,結(jié)扎右側(cè)頸總動(dòng)脈,右側(cè)頸內(nèi)動(dòng)脈遠(yuǎn)心端插管連接冷灌注系統(tǒng),右側(cè)頸內(nèi)靜脈遠(yuǎn)心端及雙側(cè)股靜脈近心端插管連接超濾復(fù)溫裝置,建立腦局部體外循環(huán)。夾閉雙側(cè)頸外靜脈、左側(cè)頸內(nèi)動(dòng)脈和頸內(nèi)靜脈(四血管阻斷冷灌注組還要阻斷雙側(cè)椎動(dòng)脈),經(jīng)右頸內(nèi)動(dòng)脈遠(yuǎn)心端輸入4.0±0.5℃冷灌注液(兩血管阻斷等溫灌注組輸入38.0℃灌注液),同時(shí),自右側(cè)頸內(nèi)靜脈遠(yuǎn)心端及右側(cè)股靜脈近心端回流靜脈血,回流液超濾復(fù)溫后經(jīng)左側(cè)股靜脈近心端回輸至體循環(huán),維持腦溫在14.3～16℃之間60min。手術(shù)前后行頭顱MRI檢查,手術(shù)中持續(xù)行腦電圖監(jiān)護(hù)并監(jiān)測(cè)生命體征及血流動(dòng)力學(xué)指標(biāo)變化,術(shù)后每周行神經(jīng)功能缺失評(píng)分,腦組織及主要臟器行光鏡觀察。結(jié)果:在10只實(shí)驗(yàn)猴中,兩血管阻斷冷灌注組4只恒河猴術(shù)中、術(shù)后血流動(dòng)力學(xué)穩(wěn)定,灌注60min后安全復(fù)蘇并長期存活,術(shù)后頭顱MRI檢查未見異常,術(shù)后腦電圖正常,術(shù)后神經(jīng)功能評(píng)分無異常,主要器官組織形態(tài)未見異常;兩血管阻斷等溫灌注組2只恒河猴及四血管阻斷冷灌注組4只恒河猴于灌注60min后均未能安全復(fù)蘇,全部死亡,主要器官組織形態(tài)可見不同程度異常。結(jié)論:猴腦在選擇性超深低溫狀念下,阻斷雙側(cè)頸總動(dòng)脈血流60min后可安全復(fù)蘇,斷血流及復(fù)蘇對(duì)血流動(dòng)力學(xué)、腦組織及神經(jīng)功能無明顯影響。
[Abstract]:Objective: to study the method of resuscitation model of selective ultra-deep hypothermia hemodialysis in monkey brain and standardize the animal model. Methods Ten healthy rhesus monkeys aged 4-10 years old were randomly divided into three groups: four vessels (bilateral common carotid artery and vertebral artery) blocking cold perfusion group, two vessels (bilateral common carotid artery) blocking cold perfusion group. Two vessels (bilateral common carotid artery) blocked isothermal perfusion group. Open bilateral carotid sheath, ligate right common carotid artery, intubate distal end of right internal carotid artery to connect cold perfusion system, intubate distal end of right internal jugular vein and proximal heart of bilateral femoral vein to connect with ultrafiltration rewarming device to establish local cerebral cardiopulmonary bypass. Occlusion of bilateral external jugular veins, Left internal carotid artery and internal jugular vein (bilateral vertebral artery were blocked in cold perfusion group by four vessels), 4.0 鹵0.5 鈩，

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