發(fā)布時間：2018-05-10 23:20

  本文選題：神經(jīng)調(diào)控 + 兔�。� 參考：《廈門大學(xué)》2014年碩士論文

【摘要】：目的：實驗的第一階段通過利用爆炸沖擊波與鐵屑碎片結(jié)合,建立了一種與實際情況接近、操作簡單、質(zhì)控標準化、穩(wěn)定性高、可重復(fù)性好的兔腦爆炸彈片傷模型,并觀察實驗兔的傷情變化。實驗的第二、三階段通過利用第一階段建立的簡易兔腦爆炸彈片傷模型的方法制作動物模型,并分別觀察及探討了迷走神經(jīng)電刺激對腦爆炸彈片傷后腦組織病理、水腫變化的影響,以及對腦及全身炎癥反應(yīng)和自主神經(jīng)系統(tǒng)功能紊亂的調(diào)節(jié)作用。 方法：實驗的第一階段選取雄性新西蘭大白兔24只,隨機分成預(yù)實驗組(4只)、空白對照組(4只)、假手術(shù)組(6只)、爆炸彈片傷組(10只),采用自行設(shè)計的爆炸裝置,爆炸經(jīng)過開顱處理后的兔腦右側(cè)頂葉皮質(zhì)。觀測傷后兔生命體征、頭顱CT表現(xiàn)、腦組織病理。通過對簡易兔腦爆炸彈片傷模型質(zhì)控性、穩(wěn)定性高和可重復(fù)性的研究,建立合適的動物模型,實驗進入第二、三階段。在實驗的第二階段中,選取另外24只雄性新西蘭大白兔按隨機數(shù)字表法分為假手術(shù)組(6只)、爆炸彈片傷組(10只)和爆炸彈片傷+迷走神經(jīng)刺激組(8只),爆炸彈片傷組和爆炸彈片傷+迷走神經(jīng)刺激組按照以上方法建立兔腦爆炸彈片傷模型,爆炸彈片傷+迷走神經(jīng)刺激組爆炸傷后接受右側(cè)頸迷走神經(jīng)電刺激(10V,5HZ,5ms,20min)。對各組實驗兔進行血清.(傷后6h)和腦組織勻漿(傷后24h)TNF-a、IL-1β和IL-10濃度檢測及腦組織含水量測定,并觀察傷后24h實驗兔腦組織病理變化。在實驗的第三階段中,另選32只雄性新西蘭大白兔按隨機數(shù)字表法分為假手術(shù)組(8只)、爆炸傷組(12只)和爆炸彈片傷+迷走神經(jīng)刺激組(12只),爆炸傷組和爆炸彈片傷+迷走神經(jīng)刺激組制作兔腦爆炸傷模型,爆炸彈片傷+迷走神經(jīng)刺激組爆炸傷后接受右側(cè)頸迷走神經(jīng)電刺激(10V,5HZ,5ms,20min)。對各組兔進行血清(傷后8h及24h)和腦脊液(傷后24h) TNF-a和IL-10濃度檢測及腦組織含水量測定,并記錄各組實驗兔傷前、傷后6h-8h和22h-24h三個時間長度為2h的長城心電圖。 結(jié)果：實驗兔腦爆炸彈片傷后頭顱CT檢查可見明顯的腦挫傷、腦出血,并有顱內(nèi)積氣和鐵屑殘留等開放性顱腦損傷的表現(xiàn)；腦組織切片呈現(xiàn)神經(jīng)元變性壞死、腦組織水腫、出血等病理改變。在腦爆炸傷早期(傷后6h-8h),爆炸彈片傷組兔血清和腦內(nèi)促炎因子TNF-a和IL-1p濃度及腦組織含水量顯著高于假手術(shù)組和迷走神經(jīng)刺激組(P0.01),而抗炎因子IL-10濃度介于假手術(shù)組和迷走神經(jīng)刺激組之間(P0.05)。在腦爆炸傷后期(24h),爆炸彈片傷組兔血清和腦內(nèi)促炎因子TNF-a濃度及腦組織含水量顯著高于假手術(shù)組和迷走神經(jīng)刺激組(P0.05),抗炎因子IL-10濃度顯著低于假手術(shù)組和迷走神經(jīng)刺激組(P0.05)；而假手術(shù)組與迷走神經(jīng)刺激組之間抗炎因子IL-10濃度差異不明顯(P0.10)。與假手術(shù)組相比,在腦爆炸彈片傷早期,爆炸彈片傷組和爆炸彈片傷+迷走神經(jīng)刺激組反映自主神經(jīng)系統(tǒng)功能平衡的指標低頻/高頻(LF/HF)比值顯著升高(P0.01)；在腦爆炸彈片傷后期,爆炸彈片傷組LF/HF比值明顯降低(P=0.01),而爆炸彈片傷+迷走神經(jīng)刺激組無顯著變化(P=0.320)。 結(jié)論：本實驗建立的兔腦爆炸彈片傷模型符合顱腦爆炸傷模型的影像學(xué)和病理學(xué)等特點,并且簡便易行、質(zhì)控標準,可應(yīng)用于基層顱腦爆炸傷的基礎(chǔ)研究。迷走神經(jīng)電刺激可以減輕腦爆炸彈片傷兔腦組織水腫程度,降低血清及腦組織內(nèi)TNF-a和IL-1β的濃度,升高IL-10的濃度,改善腦內(nèi)及全身炎癥反應(yīng)程度從而發(fā)揮對腦爆炸彈片傷兔的腦保護作用。迷走神經(jīng)電刺激可以改善和調(diào)控自主神經(jīng)系統(tǒng)功能平衡,調(diào)節(jié)呼吸循環(huán)系統(tǒng)功能,發(fā)揮促進腦爆炸彈片傷兔良好預(yù)后的作用。
[Abstract]:Objective: in the first stage of the experiment, by combining the blast shock wave with the iron debris, a rabbit model of explosive fragment injury was established, which was close to the actual situation, the operation was simple, the quality control was standardized, the stability was high and the repeatability was good, and the injury changes of the experimental rabbits were observed. The second, third stage of the test was established by the first stage. The animal model was made by the model of rabbit brain exploding bullet wound, and the effects of electric stimulation of the vagus nerve on brain tissue pathology, edema change and the regulation of brain and systemic inflammatory response and autonomic nervous system dysfunction were observed and discussed respectively.
Methods: the first stage of the experiment was to select 24 male New Zealand white rabbits, randomly divided into pre experimental group (4), blank control group (4), sham operation group (6), explosive fragment injury group (10), using self designed explosive device to explode the right parietal cortex of rabbit brain after craniotomy. The signs of life, CT and brain of the rabbit after injury were observed. Through the study of the quality control, high stability and repeatability of the simple rabbit brain explosion bullet wound model, a suitable animal model was established and the experiment entered the second, third stage. In the second stage of the experiment, the other 24 New Zealand white rabbits were divided into the sham group (6) and the explosive fragment group (10) according to the random number table method. The explosive fragment injury group and the vagus nerve stimulation group (8), the explosion bullet wound group and the explosive fragment injury + vagus nerve stimulation group established the rabbit model of the explosion bullet wound according to the above methods, and the explosive bullet wound + vagus nerve stimulation group received the right cervical vagus nerve stimulation (10V, 5HZ, 5ms, 20min) after the blast injury. After 6h) and brain tissue homogenate (post injury 24h) TNF-a, IL-1 beta and IL-10 concentration detection and determination of brain tissue water content, and observe the pathological changes of brain tissue in 24h experimental rabbits after injury. In the third stage of the experiment, 32 New Zealand white rabbits were divided into sham group (8) according to random number table method, explosion injury group (12) and explosive fragment injury + fan walk The nerve stimulation group (12), the explosion injury group and the explosive fragment injury + vagus nerve stimulation group made the rabbit brain explosion injury model, the explosion bullet wound + vagus nerve stimulation group received the right cervical vagus nerve stimulation (10V, 5HZ, 5ms, 20min). The serum (8h and 24h after injury) and the cerebrospinal fluid (24h) TNF-a and IL-10 concentrations were detected in each group of rabbits. And the water content of brain tissue was measured. The electrocardiogram of the the Great Wall with three time 2h of 6h-8h and 22h-24h after injury was recorded.
Results: the head CT examination of the rabbit brain explosion shrapnel showed obvious brain contusion, cerebral hemorrhage, and the expression of open craniocerebral injury, such as intracranial gas and iron residue, and the pathological changes of neuron degeneration and necrosis, brain edema, bleeding and other pathological changes. In the early stage of brain explosion injury (6h-8h after injury), rabbit blood was injured by explosive fragment. The concentration of TNF-a and IL-1p in the brain and brain water content in the brain and brain tissue were significantly higher than that of the sham operation group and the vagus nerve stimulation group (P0.01), but the concentration of anti inflammatory factor IL-10 was between the sham operation group and the vagus nerve stimulation group (P0.05). In the late stage of the brain explosion injury (24h), the serum and brain proinflammatory factor TNF-a concentration and brain group in the rabbits in the explosive fragment injury group were in the brain group and brain group. The water content of the fabric was significantly higher than that of the sham operation group and the vagus nerve stimulation group (P0.05), the IL-10 concentration of the anti inflammatory factor was significantly lower than that of the sham operation group and the vagus nerve stimulation group (P0.05), but the difference of the concentration of anti inflammatory factors IL-10 between the sham operation group and the vagus nerve stimulation group was not significant (P0.10). The ratio of low frequency / high frequency (LF/HF) to the functional balance of the autonomic nervous system was significantly increased (P0.01), and the LF/HF ratio of the explosive fragment was significantly decreased (P=0.01) in the late stage of the explosion of the brain exploded fragment (P=0.01), but there was no significant change in the explosive fragment and the vagus nerve stimulation group (P=0.320).
Conclusion: the model of rabbit brain explosion bullet wound in this experiment is conformed to the imaging and pathological features of the model of craniocerebral explosive injury, and it is simple and easy to use. The standard of quality control can be applied to the basic study of brain explosion injury at the base level. The electric stimulation of vagus nerve can reduce the degree of brain edema in rabbits injured by the brain explosions and reduce the serum and brain tissue. The concentration of TNF-a and IL-1 beta, increase the concentration of IL-10 and improve the degree of inflammation in the brain and the whole body, thus exerting protective effect on the brain of rabbits injured by brain explosions. Electrical stimulation of the vagus nerve can improve and regulate the function balance of the autonomic nervous system, regulate the function of the respiratory circulatory system, and promote the good prognosis of the rabbit with the brain explosion flick.

【學(xué)位授予單位】：廈門大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R651.15

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本文編號：1871371