Shimoda M, Yamada S, Yamamoto I, Tsugane R, Sato O
Department of Neurosurgery, Tokai University School of Medicine, Kanagawa, Japan.
Acta Neurochir (Wien). 1989;99(3-4):127-34. doi: 10.1007/BF01402321.
Cisternal and/or ventricular cerebrospinal fluid (CSF) and arterial blood lactate and acid-base balance were measured serially in 38 patients with aneurysmal subarachnoid haemorrhage (SAH). Based on daily clinical assessment, the patients and accordingly the samples were divided into two groups according to the grading of the World Federation of Neurosurgical Societies (W.F.N.S.). In cisternal CSF, samples of Grade III-V showed significantly higher lactic acidosis than those of Grade I-II. The time course of lactate and pH in poor prognosis groups had a significant tendency of lactic acidosis, especially on the 5th, 6th, 7th day after SAH. Ventricular CSF lactate increased even without CSF acidosis in Groups III-V. Measurement of CSF lactate, especially from the cisterna magna is useful as an indicator of prognosis and changes of intracranial environment following SAH.
对38例动脉瘤性蛛网膜下腔出血（SAH）患者连续测量了脑池和/或脑室脑脊液（CSF）以及动脉血乳酸和酸碱平衡情况。根据每日临床评估，按照世界神经外科协会联盟（W.F.N.S.）分级标准，将患者及相应样本分为两组。在脑池CSF中，Ⅲ - V级患者样本的乳酸酸中毒显著高于Ⅰ - Ⅱ级患者。预后不良组乳酸和pH值的时间变化过程有明显的乳酸酸中毒倾向，尤其是在SAH后的第5、6、7天。Ⅲ - V组即使在没有CSF酸中毒的情况下，脑室CSF乳酸也会升高。测量CSF乳酸，特别是枕大池的CSF乳酸，对于SAH后预后及颅内环境变化具有指示作用。
