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目的 探讨凝血酶在脑出血后脑水肿形成机制中的作用以及水蛭粉治疗脑水肿的疗效。方法 分别制作大鼠自体全血、凝血酶、肝素抗凝血、生理盐水及假手术脑血肿模型 ,观察不同时间血肿周围脑组织含水量 ,Na+ 、K+ 含量的变化以及病理改变 ;并观察水蛭粉 (2 5 0mg/kg口服 ,每天 2次 ,治疗 5d)治疗脑水肿的疗效。结果 大鼠脑内注射全血或凝血酶后 ,脑组织的含水量、电解质含量的变化相一致 ;在 2 4h时 ,脑水含量、Na+ 含量较其它 3组高 ,而K+ 含量则较低 (P <0 0 5 )。水蛭粉治疗后脑水含量、Na+ 、Ca2 + 含量较对照组降低 ,而K+ 含量升高 (P <0 0 5 )。结论 凝血酶可能在脑出血后脑水肿形成机制中起重要作用 ;水蛭粉对大鼠全血和凝血酶导致脑水肿有显著影响。
Objective To investigate the role of thrombin in the pathogenesis of cerebral edema after intracerebral hemorrhage and the therapeutic effect of leech powder on cerebral edema. Methods Whole blood, thrombin, heparin anticoagulant blood, normal saline and sham-operated cerebral hematoma model were made in rats respectively. The changes of brain water content, Na +, K + contents and pathological changes were observed at different time points. (250mg / kg orally, twice a day for 5 days) to treat cerebral edema. Results After brain injection of whole blood or thrombin, the brain water content and electrolyte content were consistent. At 24 hours, the content of brain water and Na + were higher than those of the other three groups, while the content of K + was lower P <0 0 5). After leech powder treatment, brain water content, Na +, Ca2 + content decreased compared with the control group, while the K + content increased (P <0 05). Conclusion Thrombin may play an important role in the pathogenesis of cerebral edema after intracerebral hemorrhage. Leech powder has a significant effect on cerebral edema induced by whole blood and thrombin in rats.