兔急性弥漫性颅高压模型TCD参数与颅内压和脑灌注压的相关性研究

目的采用兔急性弥漫性颅高压模型，研究经颅多普勒（TCD）参数与颅内压（ICP）和脑灌注压（CPP）的相关性。方法新西兰兔20只，随机分组：A组（对照组）8只，枕大池穿刺后不注入林格氏液；B组（实验组）12只，枕大池穿刺后逐步持续注入林格氏液。穿刺前、穿刺后每隔15 min监测ICP、HR、MAP、R及TCD各参数，并计算出CPP。结果A组各参数穿刺前后各时点比较无统计学差异。随着ICP的升高，B组TCD各参数与ICP、CPP有密切线性关系；TCD的变化发生在生命体征改变之前，更早于Cushing反应；在濒死前期，TCD出现一“反跳”现象，出现“反跳”的兔83.3%死亡。结论TCD的变化能较早地反映ICP和CPP的变化，同时ICP增高晚期出现的特征性“反跳”现象提示预后极差。

Relation between Transcranial Doppler,Intracranial Pressure and Cerebral Perfusion Pressure of Acute Diffuse Intracranial Hypertension in Rabbits

Objective To study the correlation between the TCD parameters,intracranial pressure（ICP） and cerebral perfusion pressure（CPP） in acute diffuse intracranial hypertension model of rabbits.Methods The experiments were performed on the twelve rabbits（Group B）,which were continuously infused Ringer＇s solution via the cisterna magna while in control group（Group A） were not.ICP、HR、MAP、R and TCD parameters before and every 15 minutes after puncture were monitored,then the CPP was calculated out.Results In Group A,there was no significant difference before and after puncture.In Group B,there were closely linear correlations between the changes of the TCD parameters and ICP,or TCD parameters and CPP.The changes of the TCD happened before the changes of vital signs,when were more earlier than the Cushing＇s reaction occurred.In the protophase before death,＂rebounding＂ phenomenon occurred in TCD,in which 83.3% died.Conclusions In the acute diffuse intracranial hypertension rabbit model,the changes of the TCD can reveal the variations of ICP and CPP in advance.The special ＂rebounding＂ phenomenon occurs in later stage of intracranial hypertension,which highly illustrates poor prognosis.