大鼠心肺复苏后脑水肿的变化及肾上腺素对脑水肿的影响

目的:探讨心肺复苏早期脑水肿的时间变化特点,以及肾上腺素对脑水肿的影响。方法:采用窒息致大鼠心跳骤停的动物模型,并以肾上腺素组做对照,检测单纯肾上腺素注射后及心肺复苏后各时点脑组织的水含量,电镜观察脑组织超微结构的改变。结果:正常大鼠注射肾上腺素后5min内均出现脉压差增大,心率加快,同时并发心律失常;肾上腺素组注射后3h出现脑组织水含量一过性升高,6h已下降,心肺复苏组于复苏后0.5h起就出现脑组织水含量的增加,并持续至9h。结论:心肺复苏早期就出现脑水肿,开始以细胞毒性脑水肿为主,而后发生血管源性脑水肿,肾上腺素可促进细胞毒性脑水肿的形成。

Changes of brain edema after cardiopulmonary resuscitation and effect of adren aline on brain edema

Objective To study the sequent changes of cerebral edema at differ ent time points after early cardiopulmonary resuscitation (CPR), and investigate the effect of adrenaline (AD) on brain edema. Methods A rat model of cardiac ar rest (CA) was established by clamping endotracheal tube at the end of expiration . Some rats were performed with CPR and the others were injected with AD. The co ntents of brain liquid in the cerebral tissues from different time points after CPR or administration with AD were assayed and the change of the cerebral ultras tructure was observed by electronic microscope. Results The rats developed highe r pulse pressure, tachycardia and arrhythmia 5 minutes after AD injection. The c ontent of brain liquid transitorily increased 3 hours after AD injection and dec reased gradually whereas it started to increase 30 minutes after CPR and the inc rease continued for more than 8 hours. Conclusions Brain edema develops in the e arly stage of CPR. The initial edema is mainly cytotoxic and then the vasogenic edema develops. AD can accelerate the development of the cytotoxic brain edema.