血液动力学方法治疗犬脑血管痉挛的实验研究  

Symptomatic vasospasm treated with different hemodynamic therapy in dogs

作　　者：林志国[1] 戴钦舜[1] 刘恩重[1] 刘相轸[1] 邹玉梅[1] 杨遇春[1] 

机构地区：[1]哈尔滨医科大学附一院神经外科

出　　处：《中华神经外科杂志》1997年第1期19-21,共3页Chinese Journal of Neurosurgery

摘　　要：目的：寻找一种有效的治疗脑血管痉挛（ＣＶＳ）的新方法。方法：２５只ＣＶＳ犬，随机分为５组：Ａ组：对照组；Ｂ组：静点低分子右旋糖酐同时应用多巴胺升压，使红细胞压积（Ｈｃｔ）降至３０％～３２％）；Ｃ组：Ｂ＋胞二磷胆碱（ＣＤＰＣ）３０ｍｇ／ｋｇ静点；Ｄ组：等容稀释＋ＣＤＰＣ；Ｅ组：Ｄ＋多巴酚丁胺１２μｇ／ｋｇｍｉｎ。结果：（１）Ｂ、Ｃ、Ｅ组基底动脉ＴＣＤ血流速度明显高于Ｄ组：（Ｐ＜０．０５）；（２）应用ＣＤＰＣ组红细胞刚性指数（ＩＲ）由治疗前的６．８２降至治疗后的４．５２（Ｐ＜０．０５）；（３）Ｂ、Ｃ组脑水含量明显高于Ａ组（Ｐ＜０．０５）；（４）Ｂ组治疗后２例光镜下可见脑组织小灶性出血。结论：（１）等容稀释加ＣＤＰＣ和多巴酚丁胺疗法的疗效与扩容稀释疗法疗效相同，前者尤其适用于扩容稀释禁忌证的病人；（２）稀释剂中加入ＣＤＰＣ，可使红细胞变形能力增加，改善脑微循环；（３）大剂量应用多巴胺升压，部分病例可使ＣＶＳ加重。Objective: To find an effective method of cerebral vasospasm treatment. Methods: 25 dogs with vasospasm were divided randomly into 5 groups: A: control group; B: low molecular dextran with dopamine. C: B plus CDPC. D: isovolemic hemodilution plus CDPC, E: D plus Dobutamine. Results: (1) Blood velocities of basilar artery TCD in B, C, E groups (132 6±18 9cm/s; 138 4±18 3 cm/s 128±18 9 cm/s respectively) were higher than that in D group (106 9±16 4cm/s) (P<0 05). (2) Erythocyte index of rigidity (IR) in using CDPC group (4 52) is lower than that without using CDPC group (6 82) (P<0 05). (3) Water contents of the brain in B and C group (82 88±0 52,79 97±0 6 respectively) were higher than that in A group (78 70±0 43). (4) 2 dogs treated with hypervolemic hemodilution suffered from cerebral hemorrhage in B group. Conclusions: (1) There is the same effect between B and E, but the former is suitable to patients who could not be treated with hypervolemic hemodilution because of high risk. (2) CDPC can increase erythrocyte deformability and improve the brain microcirculation. (3) High dose of Dopamine may induce hypertension and worsen CVS.

关 键 词：脑血管痉挛 人工扩容稀释 血液动力学 

分 类 号：R743.905[医药卫生—神经病学与精神病学]