Оптимизация защиты мозга при тяжелой черепно-мозговой травме

Аннотация

Objects of research: Г' group (control) - 8 dogs, which apply traditional intensive therapy at craniocereberal trauma without hypothermia. 2 st group - 8 dogs, which apply drug treatment with external craniocerebral hypothermia. 3 st group - 8 dogs, which apply drug treatment with perfusion method of hypothermia. At 286 patients with heavy craniocerebral trauma, efficiency hyperventilation on a background of various methods CCH is investigated depending on type of infringement of a cerebral blood flow. Purpose: to optimize results of protection and reanimation of a brain at a severe craniocereberal trauma by perfection of a method craniocerebral hypothermia and the differentiated choice of a mode of artificial ventilation easy. Methods: the cerebral blood flow parameters estimated by transcranial Dopplerography datas. Also was definite saturation of arterial (SataO2) and venous (SatvjO2) blood oxygen, cerebral blood flow (arteriovenous difference O2), a level of lactate in peripheral blood and in liquor, parameters of intensity. Results and novelty: by complex study was proved that perfusion method of the craniocerebral hypothermia is an effective and adequate method of protection of a brain caused by hypoxia and secondary damages at severe craniocerebral trauma. It is established, that at carrying out perfusion CCH the important factor of protection of a brain from hypoxia and secondary damages to which the death of animals at severe craniocerebral trauma, is preservation on a limit of physiological norm of functioning erythrocytes owing to adaptable decrease in processes the lipid peroxidation, preservation at high enough level of activity of enzymes antioxidant system, reactions peroxide hemolysis erythrocytes and which can serve as criteria of an estimation of the forecast of efficiency of spent treatment, an outcome of disease. Practical value: it is developed and pathogenetic efficiency of a perfusion method of the CCH is proved at severe craniocerebral trauma. The algorithm of differential use hyperventilation at patients with severe craniocerebral trauma is developed depending on type of cerebral blood supply disturbance and a degree of development intracranial hypertension. Inclusion of a method perfusion method of the CCH increase efficiency of protection of a brain from hypoxia and secondary damages reduces frequency of lethal outcomes at severe craniocerebral trauma. Introduction and economic efficiency: results of research are introduced in practice of the Republican science centre of neurosurgery Health Ministry of the Republic of Uzbekistan and department of anesthesiology and resuscitation of 2-clinic of the Tashkent medical academy. Field of application: resuscitation and neurosurgery.