Kapp J P, Smith R R, Peeler D F, Morrow S, Smith E S
Department of Neurosurgery, State University of New York, Buffalo 14214.
Surg Neurol. 1988 Mar;29(3):191-3. doi: 10.1016/0090-3019(88)90004-3.
Isovolemic hemodilution has been reported to increase cerebral perfusion in humans and has been advocated as a treatment for acute cerebral infarction. This study examines the effect of isovolemic hemodilution with low-molecular-weight dextran on mortality and the incidence of neurological deficit in gerbils after internal carotid ligation. Sixty-four Mongolian gerbils were anesthetized with pentobarbital and the left internal carotid artery was ligated in both control and experimental animals. In the experimental group, blood was removed and an equal volume of dextran was injected to reestablish normal blood volume and lower hematocrit to a mean of 30.5. Control animals were not so treated. Animals were observed for neurological deficits for 24 hours after carotid ligation. The incidence of neurological deficit in control animals was 67%; it was 64% in the experimental group. Mortality within the first 24 hours was 28% in the controls and 75% in animals that were treated by hemodilution (p less than 0.001). Isovolemic hemodilution with dextran did not reduce the incidence of neurological deficit after carotid ligation in gerbils and was associated with a significant increase in mortality during the first 24 hours.
据报道，等容血液稀释可增加人体脑灌注，并被提倡作为急性脑梗死的一种治疗方法。本研究探讨低分子右旋糖酐进行等容血液稀释对沙土鼠颈内动脉结扎后死亡率及神经功能缺损发生率的影响。64只蒙古沙土鼠用戊巴比妥麻醉，对照组和实验组动物均结扎左侧颈内动脉。实验组抽取血液，注入等量右旋糖酐以恢复正常血容量，并将血细胞比容降至平均30.5。对照组动物未进行此处理。结扎颈动脉后24小时观察动物神经功能缺损情况。对照组动物神经功能缺损发生率为67%；实验组为64%。对照组24小时内死亡率为28%，血液稀释处理的动物死亡率为75%（p<0.001）。右旋糖酐等容血液稀释并未降低沙土鼠颈内动脉结扎后神经功能缺损的发生率，且与最初24小时内死亡率显著增加相关。
