脑牵拉引起脑缺血性损伤的实验研究

目的 探讨脑牵拉压(brain retraction pressure，BRP)的测量方法，研究脑牵拉引起脑缺血性损伤的危险性。方法 利用电阻应变计制作脑牵拉压的测量装置，对其定标。然后利用此装置，选用新西兰大耳白兔24只，分为对照组和20mmHg组、30mmHg组、40mmHg组，牵拉完毕后，测定局部脑血流量，标本HE染色显微镜观察其损伤。结果 该装置具有很高的灵敏性、稳定性和准确性。20mmHg的BRP牵拉30min引起轻微脑损伤和脑血流量的降低，30mmHg的BRP牵拉30min引起较重脑损伤和脑血流量的显著降低。40mmHg的BRP牵拉15min引起严重脑损伤和脑血流量的极度降低。结论 该装置可作为脑牵拉压的测量工具；牵拉时,最好将BRP控制在30mmHg以下。

Experimental study of brain ischemic injury induced by brain retraction

To investigate the method of measurement of brain retraction pressure (BRP) and observe the risks of brain ischemic injury induced by brain retraction. 24 rabbits were randomly divided into control, 20 mmHg (the brain retracted by 20 mmHg pressure), 30 mmHg (by 30 mmHg pressure), 40 mmHg (by 40 mmHg pressure) groups. BRP was determined by self-made BRP instrument. The regional cerebral blood flow (rCBF) was measured. The specimen taken from brain tissues retracted by different BRP were observed under microscope. The mild brain injuries and slight decrease in the rCBF after lasting 30 min retraction were observed in 20 mmHg and 30 mmHg groups. The severe brain injuries and significant decrease in the rCBF could be seen after retraction lasting 15 min in 40 mmHg groups. Conclusions] This instrument can be used as a tool for measuring BRP. The BRP during the brain surgery should not be more than 30 mmHg to avoid brain injuries induced by the retraction.