去骨瓣减压术对大鼠局灶性脑缺血后脑水肿、血脑屏障、脑血流变化的影响

目的:观察去骨瓣减压术对局灶性脑缺血大鼠脑水肿、血脑屏障(BBB)及脑血流(CBF)的影响,探讨该手术对缺血性脑损害的保护机制。方法:改良Koizumi′s法制作脑缺血大鼠动物模型,脑缺血后6h行去骨瓣减压术,分别在术后3和7d观察脑水肿和血脑屏障的变化,另持续观察缺血1h 去骨瓣减压2h的CBF变化。结果:去骨瓣减压术后半暗区CBF增加更加持久和有效,在术后第3天时BBB破坏范围明显缩小,术后第7天时脑水含量明显降低。结论:去骨瓣减压术对局灶性脑缺血的保护作用可能与增加半暗区CBF、改善BBB破坏和减轻脑水肿有关。

Effects of Decompressive Craniectomy on the Changes of Brain Edema, BBB and CBF after Focal Cerebral Ischemia in Rats

Aim:To explore the mechanisms of the protective effects of decompressive craniectomy on focal cerebral ischemia by investigating the changes of brain edema, BBB disruption and CBF.Methods:Focal cerebral ischemia was induced by using an endovascular occlusion technique focused on left middle cerebral artery (MCA). Decompressive craniectomy was performed at insult side 6 h after ischemia. Brain edema and BBB disruption was detected at day 3 and 7 after surgery, and the changes of CBF in penumbra and core were also measured before and after decompressive procedure. Results:CBF in penumbra was increased significantly after decompressive craniectomy. Brain water content was decreased markedly and approached to normal level at day 7 and BBB disruption was significantly improved at day 3 after decompressive surgery. Conclusion:Decompressive craniectomy has protective effects on focal cerebral ischemia by the mechanisms of improving cerebral perfusion, preventing the BBB disruption and alleviating brain edema.