通过用含抗坏血酸和镁离子的模拟脑脊液持续枕大池灌注预防症状性血管痉挛。

Prevention of symptomatic vasospasm by continuous cisternal irrigation with mock-CSF containing ascorbic acid and Mg(2+).

作者信息

Satoh Akira, Sugiyama Tatsuya, Ooigawa Hidetoshi, Nakajima Hiroyuki, Ogura Takeshi, Neki Hiroaki, Morikawa Eiharu

机构信息

Department of Neurosurgery, Stroke Center, International Medical Center, Saitama Medical University, 1397-1, Yamane, Hidaka City, Saitama, 350-1298, Japan.

出版信息

Acta Neurochir Suppl. 2010;107:115-8. doi: 10.1007/978-3-211-99373-6_19.

DOI:10.1007/978-3-211-99373-6_19

PMID:19953382

Abstract

BACKGROUND

Symptomatic vasospasm (SVS) is still a major cause of poor outcome in cases undergoing early surgical intervention for ruptured intracranial aneurysm. Among the numbers of therapeutic trials to prevent and ameliorate neurological deterioration due to SVS, removal or quenching of oxy-hemoglobin (OxyHb) from subarachnoid colts and administration of Mg(2+) (Mg) have especially been expected to be effective. In this report the authors investigated the effect of continuous cisternal irrigation (CCI) with mock CSF containing ascorbic acid (ASA) and Mg, performed after early surgery for ruptured aneurysm.

METHOD

Sixty-three cases which had received CCI were retrospectively compared with 40 control cases as to the incidence of SVS and outcome.

FINDINGS

Incidence of SVS was significantly less frequent (P < 0.05) in the CCI group (11%) than in the control group (25%). Severe and definitive SVS requiring additional specific treatment occurred only in 3.2% of the CCI group, while 22.5% in the control (P < 0.01). Overall outcome at discharge was significantly better in the CCI group than in the control (P < 0.01).

CONCLUSIONS

Postoperative CCI with ASA and Mg was definitively effective in preventing SVS and in lessening severity of SVS if it occurs.

摘要

背景

症状性血管痉挛（SVS）仍是颅内动脉瘤破裂早期手术干预患者预后不良的主要原因。在众多旨在预防和改善因SVS导致的神经功能恶化的治疗试验中，从蛛网膜下腔清除或淬灭氧合血红蛋白（OxyHb）以及给予镁离子（Mg）尤其被认为可能有效。在本报告中，作者研究了在破裂动脉瘤早期手术后进行的含抗坏血酸（ASA）和Mg的模拟脑脊液持续脑池灌洗（CCI）的效果。