CAJ | 학술논문

目的：用动物模拟开颅术，持续牵拉脑组织，切断引流之桥静脉，在术后数小时引起淤血性脑实质损害。病理观察此种静脉淤血性脑损害的发生情况。方法：成年家猫18只，随机分为A、B、C三组，A、B组各5只，C组8只。 A组开颅后在靠近上矢状窦处将一侧所有桥静脉电凝切断，5 h后缝合手术切口；B组开颅后将一50克重物加压于外侧裂中段，5 h后缝合手术切口；C组则为切断一侧所有桥静脉并将一50 g重物加压于外侧裂中段，5 h后缝合手术切口。24 h后静注伊文氏蓝染料后处死动物，取脑标本检查。结果：A、B和C组脑组织伊文氏蓝染色面积分别为3.80％、2.93％和24.83％，A、B组与C组之间存在显著差异(P<0.0l、P<0.01)；C组镜下可见蛛网膜下腔、脑实质区有出血现象，A、B组则未见明显出血现象。结论：持续牵拉脑组织合并桥静脉切断可导致血脑屏障功能受损，通透性增加。术中应注重回流桥静脉的保护、减少脑组织牵拉，从而减少淤血性脑损害的发生。
목적：용동물모의개로술，지속견랍뇌조직，절단인류지교정맥，재술후수소시인기어혈성뇌실질손해。병리 관찰차충정맥어혈성뇌손해적발생정황。방법：성년가묘18지，수궤분위A、B、C삼조，A、B조각5지，C조8지。 A조개로후재고근상시상두처장일측소유교정맥전응절단，5 h후봉합수술절구；B조개로후장일50극중물가압 우외측렬중단，5 h후봉합수술절구；C조칙위절단일측소유교정맥병장일50 g중물가압우외측렬중단，5 h후봉합 수술절구。24 h후정주이문씨람염료후처사동물，취뇌표본검사。결과：A、B화C조뇌조직이문씨람염색면적분 별위3.80％、2.93％화24.83％，A、B조여C조지간존재현저차이(P<0.0l、P<0.01)；C조경하가견주망막하강、 뇌실질구유출혈현상，A、B조칙미견명현출혈현상。결론：지속견랍뇌조직합병교정맥절단가도치혈뇌병장공능 수손，통투성증가。술중응주중회류교정맥적보호、감소뇌조직견랍，종이감소어혈성뇌손해적발생。
Objective:Animal models were used for craniotomy. Brain retraction and drainage bridging veins were severed to induce postoperative congestive brain damage several hours later, and the specimens of brain were observed pathologically. Methods: Eighteen adult cats were divided into group A, B and C. In group A(five cats), after craniotomy all bridging veins of the left cerebral hemisphere were coagulated elec trically near the superior sagittal sinus and five hours later the surgical wound was closed. In group B(five cats), a round plate weighing 50 g was pressed on the middle segment of the left Sylvian fissure for 5 hours and then the wound was closed. In group C(eight cats), both of the above interventions were performed. Twenty four hours later Evans blue was injected intravenously, then all animals were killed and the brains were removed for photography and pathological exam. Results:The ratios of Evans blue dye stained area to the total area of the left hemisphere of group A, B and C were 3. 8 %, 2. 94% and 24. 84 % respectively; sig nificant difference were found between group A, B and group C respectively(P<0. 01, P<0. 01). In group C,obvious hemorrhage was observed not only in the subarachnoid space but also in the brain parenchyma, but without notable hemorrhage in group A and group B. Conclusion:The combination of severance of bridging veins and sustained brain retraction may lead to damage of BBB and increase its permeability. More attention should be paid on the preservation of bridging veins and reduction of brain retraction to diminish the occurrence of congestive brain damage.