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.
出处
《中华神经外科杂志》
CSCD
北大核心
1997年第1期19-21,共3页
Chinese Journal of Neurosurgery
关键词
脑血管痉挛
人工扩容稀释
血液动力学
Cerebral vasospasm Isovolemic hemodilution Hypervolemic hemodilution Dopamine Dobutamine CDPC
