CAJ | 학술논문

目的探讨颈交感神经节阻滞对兔实验性蛛网膜下腔出血(SAH)后缓解脑血管痉挛(cerebrovascular spasm,CVS)的作用及其机制. 方法选择颈交感神经节阻滞模型成功的健康雄性大耳白兔18只,按随机数字表法分为三组,即假手术组(A组)、SAH组(B组)、SAH加颈交感神经节阻滞组(C组).分别于第1次注血前(T1)、注血后30 min(T2)、第1次注血后7 d(T3)取静脉血及脑脊液各2 ml于低温冰箱保存备用,并行脑血管造影测量基底动脉值.并于T3记录神经系统损害级别. 结果三组T1时基底动脉血管直径差异无统计学意义,T2、T3时B、C两组的基底动脉血管直径均小于A组,B组又小于C组(p＜0.01).三组T1时血浆、脑脊液一氧化氮(NO)和一氧化氮合酶(NOS)差异无统计学意义(P＞0.05),T2、T3时均低于T1,B、C组又低于A组(P＜0.01).T3时B、C组的神经功能均低于A组,C组又优于B组(P＜0.01). 结论颈交感神经节阻滞可缓解SAH后CVS,提高血清、脑脊液NO含量及NOS的活性,促进神经功能恢复.
목적 탐토경교감신경절조체대토실험성주망막하강출혈(SAH)후완해뇌혈관경련(cerebrovascular spasm,CVS)적작용급기궤제. 방법 선택경교감신경절조체모형성공적건강웅성대이백토18지,안수궤수자표법분위삼조,즉가수술조(A조)、SAH조(B조)、SAH가경교감신경절조체조(C조).분별우제1차주혈전(T1)、주혈후30 min(T2)、제1차주혈후7 d(T3)취정맥혈급뇌척액각2 ml우저온빙상보존비용,병행뇌혈관조영측량기저동맥치.병우T3기록신경계통손해급별. 결과 삼조T1시기저동맥혈관직경차이무통계학의의,T2、T3시B、C량조적기저동맥혈관직경균소우A조,B조우소우C조(p＜0.01).삼조T1시혈장、뇌척액일양화담(NO)화일양화담합매(NOS)차이무통계학의의(P＞0.05),T2、T3시균저우T1,B、C조우저우A조(P＜0.01).T3시B、C조적신경공능균저우A조,C조우우우B조(P＜0.01). 결론 경교감신경절조체가완해SAH후CVS,제고혈청、뇌척액NO함량급NOS적활성,촉진신경공능회복.
Objective To investigate the role and mechanism of cervical sympathetic ganglia block in alleviation of cerebrovascular spasm (CVS) of rabbits after subarachnoid hemorrhage ( SAH ).Methods A total of 18 healthy male white rabbits whose cervical sympathetic ganglia were successfully blocked were randomly divided into three groups:sham operation group (Group A),SAH group (Group B) and SAH with cervical sympathetic ganglia block group (Group C).Venous blood (2 ml) and cerebrospinal fluid (2 ml) were obtained before the first blood injection ( T1 ),at 30 minutes after injection ( T2 ) and at day 7 after injection ( T3 ),respectively,and conserved in a low temperature refrigerator for spare use.Basilar artery value at T1,T2 and T3 was measured via cerebral angiography.The degree of damage to nervous system at T3 was recorded. Results There was no significant difference in diameter of basilar artery at T1 among three groups.At T2 and T3,the diameters of basilar artery of Groups B and C were shorter than that of Group A,with Group B shorter than Group C,with statistical differences ( P ＜0.01 ).There were no significant differences in NO and NOS in plasma and cerebrospinal fluid at T1 among three groups (P＞0.05).NO and NOS contents at T2 and T3 were lower than those at T1,with Group A lower than Groups B and C,with statistical differences (P＜0.01 ).At T3,the nerve function of Groups B and C were better than that of Group A,with Group C better than Group B ( P ＜0.01 ).Conclusion Cervical sympathetic ganglia block relieves CVS,increases NO content and NOS activity in plasma and cerebrospinal fluid and promotes neural functional recovery after SAH.