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目的探讨SAH后软脑膜微循环的动态变化。方法采用Wistar大鼠雌雄各半 ,将动物随机分入非SAH组和SAH组 ;非SAH组于股动脉抽血0.4ml后 ,枕大池注入0.3ml生理盐水 ;SAH组于股动脉抽血0.4ml后 ,枕大池注入经冻 -溶方法制备的自体动脉血溶解物0.3ml。以矢状缝外3mm、前囟后3mm为中心制备一直径约0.6cm区域的观察骨窗 ,去除颅骨内板、硬脑膜和蛛网膜。用微循环显微镜观察并通过摄像系统从微机屏幕上观察软脑膜微循环并录制图像 ,MCIP微循环图像处理系统分析。实验过程中保持环境温度于(26±2)℃。结果在非SAH组大鼠 ,脑池注入生理盐水前后软脑膜微血管管径、血流流速和流态均无明显改变 ,软脑膜微血管表面光洁 ,血供较丰富 ,微动脉、微静脉不完全伴行 ,常因出入脑实质而形成血管盲端 ,除少数A4级微动脉呈线粒流外 ,其它各级微血管均呈线流 ,血流快速而无凝集现象。SAH组和溶媒组大鼠在脑池注入动脉血裂解物后软脑膜微循环变化相似 ,微动脉、微静脉逐渐出现收缩变细 ,流速减慢 ,出现红细胞中至重度凝集 ,有的微血管出现血流停滞、摆动甚至微静脉向微动脉的逆流动。SAH后5min ,SAH组软脑膜微动脉管径和微静脉管径分别减低至术前的60.8 %和70.0 % ,在脑池注入自体动脉血溶解物结束后2h内 ,持续维持于低水平状态 ,
Objective To investigate the dynamic changes of pia mater microcirculation after SAH. Methods Wistar rats were randomly divided into non-SAH group and SAH group. The non-SAH group was infused with 0.4ml femoral artery and 0.3ml saline into the cisterna magna. SAH group was drawn 0.4ml After injection into the occipital cistern, 0.3 ml of autologous arterial lysate prepared by the freeze-thawing method was injected. A 3 mm diameter sagittal suture and 3 mm anterior bregma were used to prepare an observation bone window of about 0.6 cm in diameter. The skull plate, dura mater and arachnoid were removed. Using microcirculation microscope observation and through the camera system from the computer screen to observe the microcirculation and recording images, MCIP microcirculation image processing system analysis. During the experiment keep the ambient temperature at (26 ± 2) ℃. Results In non-SAH group, there were no significant changes in the diameter, flow velocity and flow pattern of the pia mater before and after injection of saline in the cisterna. The surface of the pia mater microvessel was smooth and the blood supply was more abundant. The arterioles and venules were incomplete Line, often due to the brain into the parenchyma and the formation of the blind end, except for a small number of A4-level arteries were mitochondrial flow, the other microvascular at all levels were linear flow, rapid blood flow without agglutination. In the SAH group and the vehicle group, the changes of leptomeningeal microcirculation were similar after the arterial blood lysate was injected into the cerebral cisterna. The arterioles and venules of the SAH group and the ventricular group were gradually contracted and thinned, the flow velocity was slowed down, the erythrocytes were moderately to severely aggregated, and some microvascular blood appeared Flow stagnation, swinging and even venous to micro-arterial counter-flow. SAH group 5min after SAH group, SAH group diameter and venous diameter of the microvessel were reduced to preoperative 60.8% and 70.0%, respectively, within 2h after the end of injection of autologous arterial blood lysate in the cistern, sustained at a low level,