急性实验性大脑占位改变时呼吸骤停的中枢机制

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实验在26只氨基甲酸乙酯麻醉的兔上进行,通过向蛛网膜下腔埋入的小橡胶囊内注入人工脑脊液,造成急性脑占位改变动物模型。主要结果如下:(1)延髓封闭组(n=6)。注液扩囊使潮气量(V_T)减小,动脉血压(BP)下降,注液量增加引起呼吸暂停,BP呈双相反应。反复注液扩囊,可使引起呼吸暂停所需的注液量(称“停息阈”)呈进行性减少,由首次的1.5±0.25ml降至0.35±0.07ml,动物出现小脑疝及脑干下移。(2)暴露延髓腹侧组(n=11)。其首次停息阈为0.70±0.16ml。其中4只兔反复注液产生脑干向切口疝出,并嵌顿于游离骨缘,其停息阈降低至0.10-0.16ml。(3)于4只兔的延髓腹侧压力敏感区敷贴浸润印防已毒素的滤纸片后,反复注液扩囊虽引起脑干疝和嵌顿,但停息阈稳定在0.45-0.50ml,另有4只实验兔,用印防已毒素后20min再扩囊,其首次停息阈为1.17±0.25ml;还有5只兔,在反复扩囊使停息阈下降至稳定值后,再给予印防已毒素,其停息阈又回升,并超过首次停息阈。提示急性实验性颅内占位改变引起的呼吸抑制和呼吸暂停与延髓腹外侧受压导致延髓压力敏感结构激活有关。 The experiments were performed on 26 urethane anesthetized rabbits, and the animal model of acute brain-mass change was created by injecting artificial cerebrospinal fluid into the small rubber capsule embedded in the subarachnoid space. The main results are as follows: (1) medulla oblongata group (n = 6). Infusion balloon inflation tidal volume (V_T) decreased, arterial blood pressure (BP) decreased, increased fluid volume caused by apnea, BP was biphasic response. Repeated infusion of fluid, can cause the amount of fluid required to cause apnea (referred to as the “stop threshold”) showed a progressive decrease from the first 1.5 ± 0.25ml to 0.35 ± 0.07ml, animals showed cerebellar hernia and brainstem Move down. (2) The medulla oblongata group was exposed (n = 11). The first stop threshold was 0.70 ± 0.16ml. Four rabbits were injected repeatedly to produce brain stem incision hernia, and implanted in the free bone margin, the resting threshold reduced to 0.10-0.16ml. (3) Four rabbit’s medulla oblongata pressure-sensitive area was applied with infiltration of anti-toxin filter paper, although repeated infusing cysts caused brainstem hernia and incarceration, but the resting threshold was stabilized at 0.45-0.50ml, Another 4 experimental rabbits, with anti-toxin after printing and then re-expansion of the balloon 20min, the first stop threshold was 1.17 ± 0.25ml; there are 5 rabbits in the repeated expansion of the capsule to the resting threshold dropped to a stable value, and then give the Indian Toxic toxin, its stop threshold has rebounded and exceeded the threshold for the first stop. It is suggested that respiratory depression and apnea caused by acute experimental intracranial space-occupying changes are related to activation of pressure-responsive bulbar medulla oblongata.
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