| Objectives Research the influence of decompressive craniectomy on several indexes of rats who were suffered from asphyxiant sudden cardiac arrest. The indexes we studied are as follows: the neuron specific enolase(NSE) of resurgent cerebral, the expression of S-100 b protein(S-100) and cerebral blood flow of these rats. Probe into the protective effect of protective effect on the resurgent rat brain derived from asphyxiant sudden cardiac arrest as well as it′s mechanism. The result provides a theory basis for clinical treatment of asphyxiant sudden cardiac arrest.Methods 1 Selection and sectionalization of experimental animals:48 adult male Wistar rats of pathogen- free weighing 250~370 gram were selected and divided into 3 groups at random, respectively were sham-operated group(tracheal intubation plus arteria femoralis and femoral vein catheterization), resuscitation group and large trauma cramiotomy group. Then all the 3 groups were divided into 4 subgroups respectively according to time points as follows: Sham-operated group: 6th hour, 12 th hour and 48 th hour after the operation. Resuscitation group and large trauma cramiotomy group: 6th hour, 12 th hour and 48 th hour after the restoration of spontaneous circulation(ROSC). Each subgroup of the total 16 subgroups was consisted of 4 rats who have fasted for 12 hours excepted water.2 Manufacture of animal models:Cardiac arrest models of rats were made by the improved asphyxia method. Then the resuscitation group was treated by cardio-pulmonary resuscitation(CPR), the large trauma cramiotomy group was treated by CPR and large trauma cramiotomy 1 hour after CPR while the sham-operated group was treated by tracheal intubation plus arteria femoralis and femoral vein catheterization. 3 Large trauma cramiotomy of the large trauma cramiotomy group:Rats of the large trauma cramiotomy group were treated by large trauma cramiotomy after 1 hour of CPR.4 blood stream monitor of middle cerebral artery after operations:Monitor the blood stream of rats′middle cerebral artery respectively 6 hours, 12 hours, 24 hours and 48 hours after the operations by laser doppler fiowmeter(LDF).5 Blood sample collection:Detect contents of NSE and expressions of S100 b in venous bloods of these rats by ELIISA Cut off their heads to take out the brains which would be stained by HE. All the experimental indexes above were taken into consideration to analyze their correlation to large trauma cramiotomy.6 Statistical method:Data in this article were represented by mean ± standard deviation(M±SD). Repeated measures analysis of variance and multivariate analysis of variance were made by general linear model(GLM) of SPSS 17.0.Results 1 Blood stream of middle cerebral artery: Compared with the sham-operated group, the blood streams of middle cerebral artery of the resuscitation group and the large trauma cramiotomy group were began to reduce 6 hours after the return of spontaneous circulation(ROSC), and the reductions were continue to the 48 th hour, which was statistically significant(P<0.05). Compared with the resuscitation group, the reduction of the blood stream of middle cerebral artery of the large trauma cramiotomy group from the 6th hour to the 8t h hour after ROSC was unconspicuous, but the results of the 6t h, 12 th and 48 th hour had significant difference(P<0.05), and the results of the 24 t h hour after ROSC had more significant difference(P<0.01).2 NSE protein concentration in serum: Compared with the sham-operated group, the NSE protein concentrations in serum of the resuscitation group and the large trauma cramioto my group were began to increase obviously 6 hours after the return of spontaneous circulation(ROSC), and the growths were continue to the 12 th hour and reached the peak, then reduced from the 24 t h to the 48 th hour, which was statistically significant(P<0.01). Compared with the resuscitation group, the content change of NSE protein of the large trauma cramiotomy group in 6 hours after ROSC was unconspicuous(P>0.05), but the contents of NSE protein of the 12 t h, 24 t h and 48 t h hour were reduced obviously so that had significant difference(P<0.01).3 S100 b protein concentration in serum: Compared with the shamoperated group, the S100 b protein concentrations in serum of the resuscitation group and the large trauma cramiotomy group were began to increase obviously 6 hours after the return of spontaneous circulation(ROSC), and the growths were continue to the 12 th hour and reached the peak, then reduced from the 24 t h to the 48 th hour, which was statistically significant(P<0.01). Compared with the resuscitation group, the contents of S100 b protein of the 6t h, 12 t h, 24 t h and 48 th hour were reduced obviously so that had significant difference(P<0.01).Conclusions Large trauma cramiotomy contributes to the improvement of blood stream of middle cerebral artery after ROSC as well as the reduction of concentrations of NSE protein and S100 b protein in serum so that the craniocerebral injury will be reduced by it. |
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