| Objective(一)Establishing rat model of severe traumatic brain injury,to compare two different infusion speed of 3%hypertonic saline solution on the intracranial pressure after TBI,and text the difference of brain water content and AQP-4 and MMP-9 protein and gene expression,which can provide the safety basis for the application on the clinical patients,and provide evidence for clinical nursing.(二)30 patients selected in the neurosurgical intensive care unit who had intracranial pressure probe implantation and need for treatment with high intracranial hypertension,using two infusion rates of 3%hypertonic sodium chloride solution and to observe the patient’s intracranial Pressure changes,in order to explore the more effective infusion rates.Method(一)51 Wistar rats were caused TBI through Feeney’s method,then divided randomly into three groups,injected 3%hypertonic saline solution through the tail vein,and the infusion rate was controlled with a micro-syringe pump.The rats were divided randomly into three groups:group C(the control group),group B(the bolus infusion group),and group S(slow infusion group).12 hours after injury,randomly choose 3 rats from each group,after the sacrifice,the brain tissue was moved out from the injury side of the heads,formaldehyde-soaked after HE staining to observe the pathological structure.The others 15 rats each group were anesthetized again after the NSS tests,then the rats were incubated with electric blanket and baking lamp,the tail of the non-invasive rat blood pressure monitor was set in the rat tail,venous access was established from the tail.Infusion volume was 6ml infusion rate of the bolus infusion group was 6ml/h,the infusion rate of slow infusion group was 2ml/h,the control group didn’t take infusion.The intracranial pressure was recorded every 30 min(the mean was recorded continuously for 1 min)and the rats were sacrificed when the intracranial pressure didn’t drop anymore.Rat blood samples,brain tissue,and lung tissue were collected,the expression of AQP-4 and MMP-9 mRNA and protein in lung tissue were detected by immunohistochemistry,RT-PCR and Western Blot.(二)Thirty patients undergoing intracranial pressure probe implantation for severe craniocerebral injury were divided into two groups according to the order of hospitalization:260 ml of 3%sodium chloride solution were given,Infusion rate of intravenous infusion,fast infusion group within 1 hour,slow transmission group input in 3 hours,after administration of blood for blood gas analysis and ELISA monitoring of serum AQP-4,MMP-9 protein,serum sodium,potassium,chloride,creatinine,urea nitrogen levels.Result(一)The expression levels of AQP-4 and MMP-9 mRNA and protein in the brain were measured and compared with those in the control group(p<0.05).There was a significant difference between the two groups in reducing intracranial pressure(p<0.05),but there was a significant difference between the two groups(p<0.05).(二)Patients with the same two kinds of infusion rate can reduce intracranial pressure,but fast infusion to reduce intracranial pressure effect is more significant,there are statistical differences.The expression of AQP-4 and MMP-9 in serum was also lower in the fast infusion group than in the slow-transfusion group.There was no significant difference in the serum sodium,potassium,chloride,creatinine and urea nitrogen between the two groups before and after the administration.Conclusion(一)The male Wistar rats of body weight of 250～300g,infusion rate of 6mL/h,2mL/h of 6mL 3%hypertonic saline,can both effectively reduce the of intracranial pressure after the craniocerebral injury.(二)Both infusion rates can effectively reduce the intracranial pressure of patients after craniocerebral injury,but the bolus infusion group took effect faster. |
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