CAJ | 학술논문

目的建立渐进性颅内加压脑死亡模型,观察撤除抢救措施后脑死亡至心脏死亡过程中的生命体征变化.方法将新西兰兔15只随机分为实验对照组(A组)、脑死亡4h组(B1组)及脑死亡8h组(B2组),每组5只.A组维持麻醉8h,开颅置入10号Foley球囊导管后不加压,B1、B2组加压复制脑死亡后分别维持4、8h,监测脑死亡建立过程中平均动脉压(MAP)、心率(HR)、呼吸频率(RR)变化及撤除抢救措施后MAP、HR值变化,记录停止抢救至心脏死亡时间.结果脑死亡组颅内加压后,平均动脉压明显上升(P＜0.01)；脑死亡组在停止抢救后0.5、3.0、6.0 min时MAP、HR均低于对照组,差异有统计学意义(P＜0.05)；停止抢救后,4h组心脏存活(16.20 ±5.80) min,8h组心脏存活(15.20±3.11) min,差异无统计学意义(P＞0.05).结论渐进式颅内加压诱导脑死亡后,通过呼吸机辅助呼吸及血管活性药物等措施,能较长时间维持脑死亡机体血流动力学稳定.脑死亡后,心脏功能未随时间的延长而衰退.停止抢救后,MAP、HR呈渐进性下降.
목적 건립점진성로내가압뇌사망모형,관찰철제창구조시후뇌사망지심장사망과정중적생명체정변화.방법 장신서란토15지수궤분위실험대조조(A조)、뇌사망4h조(B1조)급뇌사망8h조(B2조),매조5지.A조유지마취8h,개로치입10호Foley구낭도관후불가압,B1、B2조가압복제뇌사망후분별유지4、8h,감측뇌사망건립과정중평균동맥압(MAP)、심솔(HR)、호흡빈솔(RR)변화급철제창구조시후MAP、HR치변화,기록정지창구지심장사망시간.결과 뇌사망조로내가압후,평균동맥압명현상승(P＜0.01)；뇌사망조재정지창구후0.5、3.0、6.0 min시MAP、HR균저우대조조,차이유통계학의의(P＜0.05)；정지창구후,4h조심장존활(16.20 ±5.80) min,8h조심장존활(15.20±3.11) min,차이무통계학의의(P＞0.05).결론 점진식로내가압유도뇌사망후,통과호흡궤보조호흡급혈관활성약물등조시,능교장시간유지뇌사망궤체혈류동역학은정.뇌사망후,심장공능미수시간적연장이쇠퇴.정지창구후,MAP、HR정점진성하강.
Objective To observe changes of vital signs from brain death to cardiac death through establishing gradual onset brain death rabbit models.Methods A total of 15 New Zealand rabbits were randomly divided into control group (group A),brain death 4 h group (group B1),and brain death 8-h group (group B2),with 5 rabbits in each group.In group A Foley balloon catheter was placed in intracalvarium only,and no brain-dead model was established.Brain-dead model was established in group B1 and group B2 by increasing intracranial pressure in a modified,slow,and intermittent way.The changes of mean arterial pressure (MAP),heart rate (HR),radical resection (RR) before pressurization and those of MAP and HR after stopping salvage were observed.Heart living time after stopping salvage was recorded.Results After intracalvarium pressurization,MAP was upgraded (P ＜ 0.01).MAP,HR of brain death group at 0.5,3.0,6.0 min after the salvage was stopped were lower than that of the control,the difference was statistically significant.The cardiac survival time of B1,B2,groups were (16.20 ±5.80) min,(15.20 ±3.11) min after life support withdrew,the difference didn't have statistical significance.Conclusion When gradual onset brain death rabbit models were established,hemodynamics could be kept steady for relatively long time.Cardiac function was not deteriorated with prolongation of time after brain death.MAP and HR were descending gradually after stopping salvage.