Kinuta Y, Ishikawa M, Hirai O, Yoshida S, Imataka K, Kobayashi S, Handa H
Department of Neurosurgery, Kyoto University, Japan.
No To Shinkei. 1987 Jul;39(7):673-8.
To evaluate the clinical usefulness for measuring lumbar subarachnoid pressure (LSP) as an index of intracranial pressure, the relation between LSP and epidural pressure (EDP) was studied by the cisternal saline infusion and bolus injection in 12 cats at the range of pressure up to 50 mmHg. In the steady state infusion (0.238 ml/min, 0.476 ml/min), the data from LSP and EDP were correlated very well and the LSP value was at least above 80-90% of EDP value at any pressure level. In the bolus injection (0.4 ml), the degree of pressure rise and the time course of both LSP and EDP were quite similar at any pressure level. However, the compliance calculated from the pressure change of LSP and EDP revealed to have a different tendency according to the baseline pressure level at bolus injection. Below 10 mmHg of EDP, the compliance calculated from LSP was usually higher that of EDP. This was considered due to the distensibility of spinal theca. But above 10 mmHg of EDP, the compliance of both LSP and EDP became almost equal and then gradually decreased as the elevation of baseline pressure at bolus injection. This was considered to be the result of disappearance of the distensible effect of spinal theca. In this study, two polyethylene tubes of different size (I. D. 0.45 mm, 0.58 mm) were used for spinal drainage tube to compare the pressure dumping effect of tube. However, on both tubes, the pulse pressure of LSP was usually smaller than that of EDP, with each having almost constant difference.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估测量腰蛛网膜下腔压力(LSP)作为颅内压指标的临床实用性,在12只猫身上通过脑池生理盐水输注和推注研究了LSP与硬膜外压力(EDP)之间的关系,压力范围高达50 mmHg。在稳态输注(0.238 ml/min,0.476 ml/min)时,LSP和EDP的数据相关性非常好,且在任何压力水平下LSP值至少高于EDP值的80 - 90%。在推注(0.4 ml)时,在任何压力水平下压力上升程度以及LSP和EDP的时间进程都非常相似。然而,根据LSP和EDP的压力变化计算出的顺应性在推注时根据基线压力水平呈现出不同的趋势。EDP低于10 mmHg时,由LSP计算出的顺应性通常高于EDP。这被认为是由于脊髓膜的可扩张性。但EDP高于10 mmHg时,LSP和EDP的顺应性几乎相等,然后随着推注时基线压力的升高而逐渐降低。这被认为是脊髓膜可扩张效应消失的结果。在本研究中,使用两根不同尺寸(内径0.45 mm,0.58 mm)的聚乙烯管作为脊髓引流管来比较管子的压力衰减效应。然而,在两根管子上,LSP的脉压通常都小于EDP,且两者差值几乎恒定。(摘要截断于250字)