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EFFECT OF PASSIVE RANGE OF MOTION EXERCISE AND PASSIVE POSITION CHANGE ON INTRACRANIAL HEMODYNAMICS IN ACUTE EXPERIMENTAL STROKE

被动运动范围练习和被动体位改变对急性实验性脑卒中颅内血流动力学的影响

基本信息

批准号：
12832006
负责人：
SOMA Masashi
金额：
$ 1.54万
依托单位：
Hirosaki University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

项目摘要

Objectives: To determine the effect of passive range of motion (PROM) exercise and head positioning on intracranial pressure (ICP) and cerebral circulation in the elevated ICP condition using intracerebral hemorrhage (ICH) model of the dog.Methodology: We induced ICH in fifteen anesthetized mongrel dogs by autologous blood injection in the deep white matter adjacent to the basal ganglia. Mean arterial blood pressure (MAP) and ICP were monitored continuously, and cerebral perfusion pressure (CPP) was calculated. We did PROM exercise (foreleg flexion, hind leg flexion, trunk flexion and trunk rotation) and changed head position from 0 degrees to 30, 60 and 0 degrees in order. Those data of ICH induced dogs were compared to those of control group (five sham-operated dogs).Results: After ICH production ten dogs whose ICP elevated above 15mmHg were divided to two groups; in group 1 (n = 5) ICP elevation was moderate (20.2 +/- 0.86 mmHg), and in group 2 (n = 5) high ICP elevation was observed (33.0 +/- 3.05 mmHg). In group 2, during foreleg flexion and trunk rotation exercise, ICP elevated significantly, CPP showed declining tendency and decreased below 60 mmHg. In group 1, there was no significant ICP change in all PROM exercise, and CPP was always kept over 70 mmHg. In head positioning, CPP lowered at 50 mmHg or less in group 2 and there was little recovery.Conclusion: In the elevated ICP of 20 mmHg or less, PROM exercise and head positioning can be done safely, however, in the elevated ICP above 30 mmHg, it may be necessary to carry out the prudent countermeasure with acute stroke rehabilitation.

目的：采用犬脑出血（ICH）模型，观察被动活动范围（PROM）运动和头部定位对颅内压（ICP）和脑循环的影响。方法：在15只麻醉的杂种犬中，通过在基底节附近的深白色物质中注射自体血诱导ICH。连续监测平均动脉压（MAP）和颅内压（ICP），计算脑灌注压（CPP）。我们进行了PROM运动（前肢屈曲、后肢屈曲、躯干屈曲和躯干旋转），并将头位从0 °依次改变为30 °、60 °和0 °。并与对照组比较结果：10只犬在脑出血后，颅内压升高到15mmHg以上，随机分为两组，每组10只。第1组（n = 5）ICP中度升高（20.2 ± 0.86 mmHg），第2组（n = 5）观察到ICP高度升高（33.0 ± 3.05 mmHg）。第2组在前屈躯干旋转运动时，颅内压明显升高，脑压呈下降趋势，下降到60 mmHg以下。在第1组中，所有PROM运动中ICP均无显著变化，CPP始终保持在70 mmHg以上。结论：在ICP升高≤ 20 mmHg时，可以安全地进行PROM锻炼和头位定位，但在ICP升高> 30 mmHg时，可能需要进行谨慎的对策和急性脑卒中康复。