【摘要】 目的探讨在小动物如兔蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)模型上经股动脉入路行选择性椎-基底动脉造影的可行性;探讨经颅多普勒(TCD)对兔SAH后CVS状况的评价效度。方法采用"枕大池二次注血法"建立兔CVS模型。术前1天和术后3天、5天行选择性椎-基底动脉造影,术前1天及术后1、2、3、4、5、6、7天行连续性的TCD检测基底动脉血流速度,从而判断CVS的变化及程度。结果 SAH组兔基底动脉管径平均值在术后第3天、5天与术前1天相比,差别有统计学意义(P<0.05),SAH组较对照组比较差别也有统计学意义(P<0.01),表明确实有CVS存在。SAH组与对照组相应天数基底动脉的平均血流速度(Vm)比较,SAH组术前1天与术后1、2、3、4、5、6、7天相比,P值均小于0.05,表明有CVS存在,制模成功。SAH组内比较得出:术后第1天Vm开始加快,第3天达高峰,直至第5天,以后开始下降。通过TCD与DSA结果比较得出:兔SAH后TCD测得的Vm>33 cm/s则认为出现了CVS,Vm>40 cm/s则肯定发生了CVS,按照以上参考标准运用χ2检验比较TCD与DSA检测SAH后CVS的有效性,两种方法在检测CVS方面差别没有统计学意义(P>0.05)。结论本实验证实经兔股动脉入路行选择性椎-基底动脉造影是完全可行的,TCD可连续监测兔基底动脉血流速度,对兔SAH后CVS状况的评价稳定可靠,TCD与脑血管造影在检测SAH后CVS方面具有良好相关性。更多还原

【Abstract】 Objective: To investigate the selective angiography of the vertebral-basal artery in cerebral vasospasm animal mode1 after subarachnoid hemorrhage in rabbit via the transfemoral route;and to study the effect of transcranial Doppler ultrasound(TCD) on evaluating cerebral vasospasm after subarachnoid hemorrhage in rabbits.Methods: Vasospasm was induced in rabbits by thedouble injections of blood into the cisterna magna.To assess the effect of cerebral vasospasm,the selective angiographies of the vertebral-basal artery were made before operation and the 3rd,5th day after operation;To assess the blood flow rate of basal artery,we made the TCD before operation and the 1st,2nd,3rd,4th,5th,6th,7th day after operation successively.Results: The selective angiography of the vertebral-basal artery in cerebral vasospasm animal model after subarachnoid hemorrhage in rabbit was made successfully.Diameter of the basilar artery was assessed by angiography.The high quality and intensity of basilar arterial TCD image can be acquired by improving frequency of ultrasound signal so that the variance of blood flow rate of the basal artery could be assessed.Conclusion: This technique can obtain selective vertebral artery angiography.TCD is easy and accurate to assess the blood flow rate of basal artery successively.There is good dependability between TCD and DSA in assessing the cerebral vasospasm after subarachnoid hemorrhage in rabbits.更多还原